Increased incidence of cholecystectomy related to gallbladder disease in France: Analysis of 807,307 cholecystectomy procedures over a period of seven years

Abstract

Purpose: Gallstones are one of the most common abdominal reasons for admission to hospital. The aim of this study was to analyze trends and outcomes in patients undergoing cholecystectomy with gallbladder related disease in France from 2008 to 2014.

Patients and methods: We carried out a population-based, retrospective cohort study using data extracted from the French nationwide hospital discharge database (PMSI). We included all patients having a cholecystectomy related to gallbladder disease from January 2008 to December 2014. Patients' demographics, primary diagnosis, procedure type, length of stay (LOS), admission in an intensive care unit, discharge disposition, complications, and in-hospital mortality were analyzed.

Results: Overall, 807,307 cholecystectomies were performed in France over the study period, with an increase in the national incidence rate from 167.5 (95%CI [166.5; 168.5]) to 182.6 (95%CI [181.6; 183.6]) per 100,000 inhabitants. Females accounted for 66.5% of procedures (P<0.001). The mean age was lower for females than for males: 52.1 versus 60.2 (P<0.001). The ratio of laparoscopic cholecystectomy significantly increased from 90% in 2008 to 94% in 2014 (P<0.001). Average inpatient LOS decreased significantly from 6.5 days in 2008 to 4.7 days in 2014 (P<0.001). Most common complication type was intra-abdominal (23.1%) for laparoscopic procedure (95%CI [22.7; 23.5]), and in-hospital mortality significantly decreased over time from 0.45% in 2008 to 0.38% in 2014 (P<0.005).

Conclusion: Our results showed that the national incidence rate of cholecystectomy related to gallbladder disease increased from 2008 to 2014.

Keywords: Cholecystectomy; Epidemiology; Laparoscopic cholecystectomy; Nationwide database; Open cholecystectomy.