title: The quality of cholecystectomy in Denmark has improved over 6-year period.
abstract: OBJECTIVE
  The Danish Cholecystectomy Database (DCD) was a nationwide quality database that existed from 2006 to 2011. The main goal (indicators) for the database was to increase the quality of cholecystectomy in Denmark by (1) reducing the number of primary open cholecystectomies, (2) increasing the proportion of outpatient surgery, (3) reducing the number of postoperative readmissions, and (4) reducing the number of bile duct injuries and other postoperative complications. The purpose of this study was to evaluate whether the DCD met these goals.
  
  
  METHODS
  Data from the DCD were used to identify all patients treated with cholecystectomy in the period from 2006 to 2011. The indicators were analyzed over time as a measure of quality of cholecystectomy and analyzed using chi-square statistics.
  
  
  RESULTS
  A total of 37,317 patients were included in the study. The registration rate in the DCD was around 90 %, except in 2011 where it was 70.7 %. The proportion of open cholecystectomies decreased from 2.6 % in 2006 to 0.9 % in 2011 (p < 0.0005). Likewise, in 2011, 80 % of patients undergoing cholecystectomy were discharged within 24 h, an increase compared to 2006 (p < 0.0005). The proportion of readmissions remained steady in the area of 10 % (p = 0.6). Bile duct injuries were low (0.3 %) and unchanged during the study period.
  
  
  CONCLUSIONS
  During the observed 6-year period, a significant increase of laparoscopic procedures was observed with more operations being performed as outpatient procedures. The proportion of readmissions and complications did not increase during this time period.
authors.affiliation: Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark, josephineprothman@gmail.com.
authors.forename: Josephine Philip
authors.initials: JP
authors.lastname: Rothman
authors.forename: Jakob
authors.initials: J
authors.lastname: Burcharth
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Pommergaard
authors.forename: Linda
authors.initials: L
authors.lastname: Bardram
authors.forename: Mads Svane
authors.initials: MS
authors.lastname: Liljekvist
authors.forename: Jacob
authors.initials: J
authors.lastname: Rosenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002763:Cholecystectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D061887:Conversion to Open Surgery; D016208:Databases, Factual; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005705:Gallbladder Diseases / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D012189:Retrospective Studies; D055815:Young Adult