title: Gallstones--an increasing problem: a study of hospital admissions in England between 1989/1990 and 1999/2000.
abstract: BACKGROUND
  The number of operations for cholelithiasis increased from the 1950s to the 1990s.
  
  
  OBJECTIVE
  To determine the time trends in cholelithiasis for hospital admissions, operations and in-hospital case fatalities in England between 1989/1990 and 1999/2000, and population mortality rates between 1979 and 1999.
  
  
  METHODS
  Hospital Episode Statistics for admissions were obtained from the Department of Health and mortality data were obtained from the Office for National Statistics.
  
  
  RESULTS
  Between 1989/1990 and 1999/2000, age-standardized hospital admission rates for cholelithiasis increased by 30% for males and 64% for females. The proportions of admissions undergoing an operation declined progressively over the study period. In 1999/2000, the frequency of operation was approximately 50-60% for most age groups, but decreased progressively with advancing age at > or = 65 years. The proportions of admissions undergoing therapeutic endoscopy increased several-fold, especially amongst older individuals. Case fatality rates declined. Mortality rates declined from 1979 to 1988, but showed no further change from 1989 to 1999.
  
  
  CONCLUSIONS
  There has been a steady increase in admission rates for cholelithiasis over the study period. Whilst the frequency of operation has declined, the proportion of patients undergoing therapeutic endoscopy has increased.
authors.affiliation: Department of Gastroenterology, St George's Hospital, London, UK. jykang@sghms.ac.uk
authors.forename: J-Y
authors.initials: JY
authors.lastname: Kang
authors.forename: C
authors.initials: C
authors.lastname: Ellis
authors.forename: A
authors.initials: A
authors.lastname: Majeed
authors.forename: J
authors.initials: J
authors.lastname: Hoare
authors.forename: A
authors.initials: A
authors.lastname: Tinto
authors.forename: R C N
authors.initials: RC
authors.lastname: Williamson
authors.forename: C J
authors.initials: CJ
authors.lastname: Tibbs
authors.forename: J D
authors.initials: JD
authors.lastname: Maxwell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002769:Cholelithiasis / Q000401:mortality* / Q000601:surgery; D016145:Endoscopy, Digestive System; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D013997:Time Factors