Multi-institutional survey of laparoscopic cholecystectomy.
Laparoscopic cholecystectomy (LC) is being used more frequently in patients undergoing gallbladder removal. Most initial studies have centered on the limited experience of a few select surgeons or institutions and may not accurately reflect the current state of LC. We used written and telephone survey tools to 103 community hospitals in Michigan to identify the utilization of LC, the criteria for training and credentialing, and patient outcome. Of 103 hospitals, 75 (73%) were involved with LC and 56% of these had < 100 beds. We found a large variation in the indications, contraindications, equipment, methods, and credentialing criteria. Major complications, including some not previously reported, were identified and occurred more frequently than previously described. LC is being widely applied and the majority of hospitals have < 100 beds. LC may carry higher risks than previously reported. Collected series and registry data that include community hospital experiences should better delineate the outcome of LC.
Moon
P O
PO
Department of Surgery, Michigan State University/Butterworth Hospital, Grand Rapids 49503.
Scholten
D J
DJ
Scheeres
D E
DE
D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data*; D000075202:Contraindications; D003406:Credentialing; D003625:Data Collection; D004059:Diffusion of Innovation; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D008824:Michigan / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology