Cholecystectomy rates, gallstone prevalence, and handling of bile duct injuries in Scandinavia. A comparative audit

Abstract

Background: This study was performed to assess three fields of surgical decision making: (a) selecting patients for cholecystectomy, (b) analyzing the value of intraoperative cholangiography (IOC), and (c) surveying the handling of bile duct (BD) injuries.

Methods: Yearly numbers of laparoscopic (LC) and open cholecystectomies (OC) were collected from official health care statistics. Data concerning handling of BD injuries were taken from each country's LC registry.

Results: From 1989 to 1995 the median cholecystectomy rate was 6.82 per 10,000 inhabitants in Denmark, 14.20 in Finland, 6.23 in Norway, and 12.17 in Sweden. Deviations from the median yearly rates in each country were -14.8% to +14.4%. Repair of BD injury was performed in the same local hospital where the injury had occurred in 68-98% of cases.

Conclusions: Patient selection differed between countries before the introduction of LC, and these differences have persisted. Few patients with BD injury were treated in referral centers.