CHOLECYSTECTOMY RATES, GALLSTONE PREVALENCE, AND HANDLING OF BILE-DUCT INJURIES IN SCANDINAVIA - A COMPARATIVE AUDIT

Background: This study was performed to assess three fields of surgica l decision making: (a) selecting patients for cholecystectomy, (b) ana lyzing the value of intraoperative cholangiography (IOC), and (c) surv eying the handling of bile duct (BD) injuries. Methods: Yearly numbers of laparoscopic (LC) and open cholecystectomies (OC) were collected f rom official health care statistics. Data concerning handling of ED in juries were taken from each country's LC registry. Results: From 1989 to 1995 the median cholecystectomy rate was 6.82 per 10,000 inhabitant s in Denmark, 14.20 in Finland, 6.23 in Norway, and 12.17 in Sweden. D eviations from the median yearly rates in each country were -14.8% to +14.4%. Repair of ED injury was performed in the same local hospital w here the injury had occurred in 68-98% of cases. Conclusions: Patient selection differed between countries before the introduction of LC, an d these differences have persisted. Few patients with ED injury were t reated in referral centers.