The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Management of acute gallbladder disease in England. BJS 2008; 95: 472-476.

Published: 29th October 2007

Authors: G. G. David, A. A. Al‐Sarira, S. Willmott, M. Deakin, D. J. Corless, J. P. Slavin et al.

Background

Recent literature suggests that early laparoscopic cholecystectomy for acute gallbladder disease is safe and efficacious, but few data are available on the management of acute gallbladder disease in England.

Method

Hospital Episode Statistics data for the years 2003–2005 were obtained from the Department of Health. All patients admitted as an emergency with acute gallbladder disease during the period from April 2003 to March 2004 were included as a cohort. Repeat emergency admissions for acute gallbladder disease, and cholecystectomies performed during the first admission, an emergency readmission or an elective admission were followed up until March 2005.

Results

Some 25 743 patients were admitted as an emergency with acute gallbladder disease, of whom 3791 had an emergency cholecystectomy during the first admission (open cholecystectomy (OC) 29·8 per cent, laparoscopic conversion rate (LCR) 10·7 per cent) and 9806 patients had an elective cholecystectomy (OC 11·3 per cent, LCR 8·3 per cent) during the study period.

Conclusion

Early cholecystectomy for acute gallbladder disease is not widely practised by surgeons in England. Open cholecystectomy is more commonly used in the emergency than in the elective setting. Early laparoscopic cholecystectomy following an emergency admission carries a higher conversion rate than elective cholecystectomy. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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