title: Influence of laparoscopic cholecystectomy on the prevalence of operations for gallstones in Norway.
abstract: OBJECTIVE
  To assess trends in the treatment of gallstone disease, by recording the number of admissions to hospital and operations; to find out if there are regional differences in the number of operations for gallstone disease; to compare these with those of other countries, and to discuss possible causative factors with special reference to introduction of laparocopic cholecystectomy.
  
  
  METHODS
  Study of medical records.
  
  
  METHODS
  University hospital, Norway.
  
  
  METHODS
  A total of 55,622 hospital stays and 28,048 operations for gallstone disease were recorded in a national registry for the 8-year period 1992-9, which comprise 99% of all admissions for gallstone disease.
  
  
  METHODS
  Data were compared for number of admissions to hospitals for gallstone disease, incidence of different operations, and trends in treatment. Different regions in Norway were also compared.
  
  
  RESULTS
  Both the number of hospital stays and the number of gallstone operations increased slightly over the period. Compared with 1992, the open cholecystectomy rate was reduced to 25%, and laparoscopic operations increased more than four times. The incidence of endoscopic procedures showed an annual increase from 1992-9, followed by a fall in 1999 to the 1992 level.
  
  
  CONCLUSIONS
  Treatment trends show a pronounced increase in laparoscopic operations, and at the same time fewer open operations. The total number of operations has increased slightly in Norway. The prevalence of operations for gallstones in Norway is the lowest reported in Western Europe. The overall number of gallstone operations in Norway is relatively small. The increase in the number of operations for gallstones in Norway was mainly caused by the increase in laparoscopic cholecystectomies. After a steady rise, there was a fall in the number of endoscopic procedures for common bile duct stones during the last year. At the same time, however, magnetic resonance cholangiopancreatography was introduced in Norway. The prevalence of gallstone disease in the population studied seems to have had little influence on the incidence of operations. Many Norwegian patients with gallstone disease who could benefit from operation are probably not being offered surgical treatment today, but are treated in an expectant manner instead.
authors.affiliation: Department of Surgery, Haukeland University Hospital, Bergen, Norway. gustav.pedersen@helse-bergen.no
authors.forename: Gustav
authors.initials: G
authors.lastname: Pedersen
authors.forename: Dag
authors.initials: D
authors.lastname: Hoem
authors.forename: Ake
authors.initials: A
authors.lastname: Andrén-Sandberg
mesh_terms: D002763:Cholecystectomy / Q000706:statistics & numerical data / Q000639:trends; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data*; D002769:Cholelithiasis / Q000601:surgery*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008499:Medical Records; D009664:Norway; D015995:Prevalence