Surgery for gallstone disease in two time periods

BACKGROUND: Laparoscopic cholecystectomy was introduced at our institution in October 1990. The perioperative results from 1.1.1991 to 31.12.1995 (first period) are compared with those from 1.1.2001 to 31.12.2005 (second period). MATERIAL AND METHODS: All patients who had undergone surgical treatment for gallstone disease at Asker and Baerum Hospital in the first or second period were included. Data retrieval was partly prospective and partly retrospective in both periods. RESULTS: Significantly more patients underwent cholecystectomy in the second than in the first period (843 vs. 342), but the proportion of patients that were operated on an acute indication was lower in the second (91 of 843) than in the first (79 of 342) period, p < 0.001. This coincided with a decline in the number of cholecystectomy patients with complications to gallstone disease (pancreatitis, cholangitis or acute cholecystitis) and a significant reduction of operating time and duration of hospital stay after the operation, whereas the number of per- and postoperative complications remained unchanged. INTERPRETATION: The number of patients operated for gallstone disease during the first 15 years of laparoscopic surgery has increased significantly. Fewer patients with acute cholecystitis are treated surgically, and the proportion of patients suffering from pancreatitis, cholangitis or acute cholecystitis before surgery appears to have declined.