Mortality Associated with the Treatment of Gallstone Disease: A 10-Year Contemporary National Experience

John M. Scollay, Russell Mullen, Gillian McPhillips, Alastair M. Thompson

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    Abstract

    Gallstones remain a common clinical problem requiring skilled operative and nonoperative management. The aim of the present population-based study was to investigate causes of gallstone-related mortality in Scotland.

    Surgical deaths were peer reviewed between 1997 and 2006 through the Scottish Audit of Surgical Mortality (SASM); data were analyzed for patients in whom the principal diagnosis on admission was gallstone disease.

    Gallstone disease was responsible for 790/43,271 (1.83%) of the surgical deaths recorded, with an overall mortality for cholecystectomy of 0.307% (176/57,352), endoscopic retrograde cholangiopancreatography (ERCP) of 0.313% (117/37,345), and cholecystostomy of 2.1% (12/578) across the decade. However, the majority of patients who died were elderly (47.6% a parts per thousand yen80 years or older) and were managed conservatively. Deaths following cholecystectomy usually followed emergency admission (76%) and were more likely to have been associated with postoperative medical complications (n = 189) than surgical complications (n = 36).

    Although cholecystectomy is a relatively safe procedure, patients who die as a result of gallstone disease tend to be elderly, to have been admitted as emergency cases, and to have had co-morbidities. Future combined medical and surgical perioperative management may reduce the mortality rate associated with gallstones.

    Original languageEnglish
    Pages (from-to)643-647
    Number of pages5
    JournalWorld Journal of Surgery
    Volume35
    Issue number3
    DOIs
    Publication statusPublished - Mar 2011

    Keywords

    • GALLBLADDER IN-SITU
    • BILE-DUCT STONES
    • ACUTE CHOLECYSTITIS
    • LAPAROSCOPIC CHOLECYSTECTOMY
    • SURGICAL MORTALITY
    • MANAGEMENT
    • CANCER
    • CHOLECYSTOSTOMY
    • COMPLICATIONS
    • MORBIDITY

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