Cholecystectomy rates, gallstone prevalence, and handling of bile duct injuries in Scandinavia. A comparative audit.
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.
Mjäland
O
O
Department of Surgery, Ullevaal Hospital, Kirkeveien 166, University of Oslo, N-0407 Oslo, Norway.
Adamsen
S
S
Hjelmquist
B
B
Ovaska
J
J
Buanes
T
T
D001649:Bile Duct Diseases / Q000453:epidemiology* / Q000209:etiology; D001652:Bile Ducts / Q000293:injuries*; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000706:statistics & numerical data*; D002769:Cholelithiasis / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology