ABSTRACT INTRODUCTION:

The introduction of laparoscopic cholecystectomy was followed by a steep increase in the cholecystectomy rate, which has remained on an unchanged, high level. The main indication for cholecystectomy in Denmark in cases with uncomplicated gallbladder stones is socially debilitating pain. The objective of the present study was to investigate whether the indication “socially debilitating pain” was reported in the patient’s file when he or she was referred to surgery.

METHODS: Hospital files for all patients referred to surgical evaluation for uncomplicated gallbladder stones from Odense University Hospital’s service area (approximately 449,000 inhabitants) within a one-year period (2014) were reviewed.

RESULTS: Among 1,003 eligible patients, a total of 516 met the inclusion criteria, 407 (78.9%) of whom underwent elective cholecystectomy. For only 89 (21.9%) of these 407 patients, the indication of socially debilitating pain was described in the patient files.

CONCLUSIONS: Our results may represent overtreatment and/or incorrect selection of patients suitable for surgery. More and larger prospective cohort studies are warranted to elucidate the indications for cholecystectomy in uncomplicated gallbladder stones.

Expanded conclusion 

For more than three quarters of the patients with uncomplicated gallbladder stones referred for cholecystectomy, the generally accepted main indication of socially debilitating pain was not described in medical files. This is problematic and could lead to overtreatment and/or incorrect selection of patients suitable for surgery. More and larger prospective studies are warranted to explore this topic.

In layman’s terms : We found patents being referred for gallbladder surgery when they general shoudn’t. Confirming unnecessary surgery treatments occurring. Incorrect diagnosis made. Fraud investigation possibly warranted. 

 

 

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Funding: none. Trial registration: not relevant


 

Source :

Pedersen B1, Ellebæk MB, Dorfelt A, Qvist N. Cholecystectomy for uncomplicated gallbladder stones does not follow evidence-based recommendations.Dan Med J 64/11 November 2017 Danish Medical JOURN