Changing work patterns for benign upper gastrointestinal and biliary disease: 1994-2007.

Area of Science:

• Surgical Technology and Practice
• Gastrointestinal and Biliary Surgery
• Bariatric and Anti-Reflux Surgery

Background:

• Surgical technology advancements influence surgical practice.
• Analysis of trends in common benign biliary and upper gastrointestinal conditions in Australia over 15 years.

Purpose of the Study:

• To determine trends in surgical caseload for specific procedures in Australia.
• To analyze the utilization of Medicare item numbers for gallstone, bariatric, and anti-reflux surgeries from 1994 to 2007.

Main Methods:

• Utilized Medicare Australia data for national and state-level analysis.
• Calculated rates for operative cholangiography, laparoscopic to open cholecystectomy conversion, and bile duct exploration.
• Determined per capita use of bariatric procedures and analyzed anti-reflux surgery trends.

Main Results:

• Increased use of intra-operative cholangiography; decreased conversion to open cholecystectomy and bile duct exploration.
• Rapid rise in restrictive bariatric procedures, followed by increased revision surgeries and adjustments.
• Significant increase in anti-reflux surgery, primarily for large hiatus hernia repair; revision anti-reflux surgery remains infrequent.

Conclusions:

• Demonstrated significant increases in laparoscopic surgical techniques, particularly for morbid obesity.
• Highlighted the growing application of specific laparoscopic procedures.
• Emphasized the need for future healthcare planning to account for these surgical trends.