title: Increased rate of cholecystectomies performed with doubtful or no indications after laparoscopy introduction: a single center experience.
abstract: BACKGROUND
  During recent years laparoscopic cholecystectomy has dramatically increased, sometimes resulting in overtreatment. Aim of this work was to retrospectively analyze all laparoscopic cholecystectomies performed in a single center in order to find the percentage of patients whose surgical treatment may be explained with this general trend, and to speculate about the possible causes.
  
  
  METHODS
  831 patients who underwent a laparoscopic cholecystectomy from 1999 to 2008 were retrospectively analyzed.
  
  
  RESULTS
  At discharge, 43.08% of patients were operated on because of at least one previous episode of biliary colic before the one at admission; 14.08% of patients presented with acute lithiasic cholecystitis; 14.68% were operated on because of an increase in bilirubin level; 1.56% were operated on because of a previous episode of jaundice with normal bilirubin at admission; 0.72% had gallbladder adenomas, 0.72% had cholangitis, 0.36% had biliodigestive fistula and one patient (0.12%) had acalculous cholecystitis. By excluding all these patients, 21.18% were operated on without indications.
  
  
  CONCLUSIONS
  The broadening of indications for laparoscopic cholecystectomy is undisputed and can be considered a consequence of new technologies that have been introduced, increased demand from patients, and the need for practice by inexperienced surgeons. If not prevented, this trend could continue indefinitely.
authors.affiliation: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Cannizzaro Hospital, Catania, Italy.
authors.forename: Elia
authors.initials: E
authors.lastname: Pulvirenti
authors.forename: Adriana
authors.initials: A
authors.lastname: Toro
authors.forename: Michel
authors.initials: M
authors.lastname: Gagner
authors.forename: Maurizio
authors.initials: M
authors.lastname: Mannino
authors.forename: Isidoro
authors.initials: I
authors.lastname: Di Carlo
mesh_terms: D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000706:statistics & numerical data*; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged