Document Detail


Increased ERCP rate following the introduction of laparoscopic cholecystectomy.
MedLine Citation:
PMID:  8845499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Over the past 5 years there has been a remarkable change in the manner in which symptomatic gallstones are surgically managed. In this study we reviewed the experience of a large HMO to determine the relationship between the rate of increase of ERCP and that of cholecystectomy. All individuals enrolled in US Healthcare's HMO-PA, in the region of southeastern Pennsylvania from 1988 through 1993, were included in the analysis. Using the HMO claims database, patients who underwent an open or laparoscopic cholecystectomy during the study period were identified. We then identified those patients who had a pre- or post- operative ERCP. Over the study period, there has been a substantial increase in cholecystectomies per 1000 members-from 1.37 in 1988 to 2.16 (p < 0.0001) in 1993. In our study population there were 1261 ERCPs performed in 979 patients with an average of 1.3 ERCPs per patient during the study period. The ERCP rate per 1000 members has increased from 0.16 to 0.56 (p < 0.0001) from 1988 to 1993, at the same time that the cholecystectomy rate was substantially increasing. The correlation for the ERCP and cholecystectomy rates from 1988 to 1993 was 0.994 (p < 0.0001). Since the introduction of laparoscopic cholecystectomy in 1989-1990, many more ERCPs are now being performed. It is necessary to determine the implications related to the rapid diffusion of laparoscopic cholecystectomy, including the effect that this technology has had on other older and stable technologies such as ERCP. Our results describe the dramatic effect that laparoscopic cholecystectomy has had on the utilization of ERCPs.
Authors:
A P Legorreta; R J Brooks; R N Staroscik; Y Xuan; G N Costantino; S L Zatz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of laparoendoscopic surgery     Volume:  5     ISSN:  1052-3901     ISO Abbreviation:  J Laparoendosc Surg     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1996-10-22     Completed Date:  1996-10-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9109598     Medline TA:  J Laparoendosc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  271-8     Citation Subset:  IM    
Affiliation:
Health Net, Woodland Hills, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Cholangiopancreatography, Endoscopic Retrograde / utilization*
Cholecystectomy, Laparoscopic* / utilization
Health Maintenance Organizations
Humans
Infant, Newborn
Pennsylvania

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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