Gallstone disease is responsible for 1.83% of the surgical deaths recorded in Scotland. - GreenMedInfo Summary
Mortality associated with the treatment of gallstone disease: a 10-year contemporary national experience.
World J Surg. 2010 Dec 23. Epub 2010 Dec 23. PMID: 21181471
Department of Surgery, Ninewells Hospital and Medical School, Dundee, D1 9SY, UK, firstname.lastname@example.org.
BACKGROUND: Gallstones remain a common clinical problem requiring skilled operative and nonoperative management. The aim of the present population-based study was to investigate causes of gallstone-related mortality in Scotland. METHODS: Surgical deaths were peer reviewed between 1997 and 2006 through the Scottish Audit of Surgical Mortality (SASM); data were analyzed for patients in whom the principal diagnosis on admission was gallstone disease. RESULTS: Gallstone disease was responsible for 790/43,271 (1.83%) of the surgical deaths recorded, with an overall mortality for cholecystectomy of 0.307% (176/57,352), endoscopic retrograde cholangiopancreatography (ERCP) of 0.313% (117/37,345), and cholecystostomy of 2.1% (12/578) across the decade. However, the majority of patients who died were elderly (47.6%≥80 years or older) and were managed conservatively. Deaths following cholecystectomy usually followed emergency admission (76%) and were more likely to have been associated with postoperative medical complications (n = 189) than surgical complications (n = 36). DISCUSSION: Although cholecystectomy is a relatively safe procedure, patients who die as a result of gallstone disease tend to be elderly, to have been admitted as emergency cases, and to have had co-morbidities. Future combined medical and surgical perioperative management may reduce the mortality rate associated with gallstones.