| Increased ERCP rate following the introduction of laparoscopic cholecystectomy. | |
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MedLine Citation:
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PMID: 8845499 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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A P Legorreta; R J Brooks; R N Staroscik; Y Xuan; G N Costantino; S L Zatz |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of laparoendoscopic surgery Volume: 5 ISSN: 1052-3901 ISO Abbreviation: J Laparoendosc Surg Publication Date: 1995 Oct |
Date Detail:
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Created Date: 1996-10-22 Completed Date: 1996-10-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9109598 Medline TA: J Laparoendosc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 271-8 Citation Subset: IM |
Affiliation:
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Health Net, Woodland Hills, California, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cholangiopancreatography, Endoscopic Retrograde
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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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