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

TY - JOUR

T1 - Mortality Associated with the Treatment of Gallstone Disease

T2 - A 10-Year Contemporary National Experience

AU - Scollay, John M.

AU - Mullen, Russell

AU - McPhillips, Gillian

AU - Thompson, Alastair M.

PY - 2011/3

Y1 - 2011/3

N2 - 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.

AB - 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.

KW - GALLBLADDER IN-SITU

KW - BILE-DUCT STONES

KW - ACUTE CHOLECYSTITIS

KW - LAPAROSCOPIC CHOLECYSTECTOMY

KW - SURGICAL MORTALITY

KW - MANAGEMENT

KW - CANCER

KW - CHOLECYSTOSTOMY

KW - COMPLICATIONS

KW - MORBIDITY

U2 - 10.1007/s00268-010-0908-3

DO - 10.1007/s00268-010-0908-3

M3 - Article

C2 - 21181471

SN - 0364-2313

VL - 35

SP - 643

EP - 647

JO - World Journal of Surgery

JF - World Journal of Surgery

IS - 3

ER -