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Minimally Invasive Surgery
Volume 2014, Article ID 635461, 5 pages
http://dx.doi.org/10.1155/2014/635461
Research Article

National Trends in the Adoption of Laparoscopic Cholecystectomy over 7 Years in the United States and Impact of Laparoscopic Approaches Stratified by Age

1Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
2Department of Surgery, Center for Translational Injury Research, University of Texas-Houston, Houston, TX 77030, USA
3Department of Surgery, Queens Medical Centre, Nottingham NG7 2UH, UK
4Department of Surgery, Duke University, Durham, NC 27710, USA

Received 2 December 2013; Revised 12 February 2014; Accepted 16 February 2014; Published 20 March 2014

Academic Editor: Casey M. Calkins

Copyright © 2014 Anahita Dua et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The aim of this study was to characterize national trends in adoption of laparoscopic cholecystectomy and determine differences in outcome based on type of surgery and patient age. Methods. Retrospective cross-sectional study of patients undergoing cholecystectomy. Trends in open versus laparoscopic cholecystectomy by age group and year were analyzed. Differences in outcomes including in-hospital mortality, complications, discharge disposition, length of stay (LOS), and cost are examined. Results. Between 1999 and 2006, 358,091 patients underwent cholecystectomy. In 1999, patients aged ≥80 years had the lowest rates of laparoscopic cholecystectomy, followed by those aged 65–79, 64–50, and 49–18 years (59.7%, 65.3%, 73.2%, and 83.5%, resp., ). Laparoscopic cholecystectomy was associated with improved clinical and economic outcomes across all age groups. Over the study period, there was a gradual increase in laparoscopic cholecystectomy performed among all age groups during each year, though elderly patients continued to lag significantly behind their younger counterparts in rates of laparoscopic cholecystectomy. Conclusion. This is the largest study to report trends in adoption of laparoscopic cholecystectomy in the US in patients stratified by age. Elderly patients are more likely to undergo open cholecystectomy. Laparoscopic cholecystectomy is associated with improved clinical outcomes.