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Routine versus sele...
Routine versus selective intraoperative cholangiography during cholecystectomy: systematic review, meta-analysis and health economic model analysis of iatrogenic bile duct injury
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- Rystedt, J. M.L. (author)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups,Skåne University Hospital
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- Wiss, J. (author)
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
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- Adolfsson, J. (author)
- Karolinska Institutet
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- Enochsson, Lars (author)
- Umeå University,Karolinska Institute,Umeå universitet,Kirurgi,Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden,Karolinska Institutet, Stockholm, Sweden; Umeå University, Umea, Sweden
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- Hallerback, B. (author)
- Department of Surgery, Northern Alvsborg Hospital, Trollhattan, Sweden,NU Hospital Group
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- Johansson, Pia, 1963- (author)
- Halmstad University,Högskolan i Halmstad,Centrum för forskning om välfärd, hälsa och idrott (CVHI)
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- Jönsson, Claes (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
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- Leander, P. (author)
- Department of Radiology, Skane University Hospital, Malmö, Sweden
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- Osterberg, J. (author)
- Karolinska Institutet
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- Montgomery, A. (author)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- 2020-12-31
- 2021
- English.
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In: BJS open. - Oxford : Oxford University Press (OUP). - 2474-9842. ; 5:2
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Abstract
Subject headings
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- Background: Bile duct injury (BDI) is a severe complication following cholecystectomy. Early recognition and treatment of BDI has been shown to reduce costs and improve patients' quality of life. The aim of this study was to assess the effect and cost-effectiveness of routine versus selective intraoperative cholangiography (IOC) in cholecystectomy. Methods: A systematic review and meta-analysis, combined with a health economic model analysis in the Swedish setting, was performed. Costs per quality-adjusted life-year (QALY) for routine versus selective IOC during cholecystectomy for different scenarios were calculated. Results: In this meta-analysis, eight studies with more than 2 million patients subjected to cholecystectomy and 9000 BDIs were included. The rate of BDI was estimated to 0.36 per cent when IOC was performed routinely, compared with to 0.53 per cent when used selectively, indicating an increased risk for BDI of 43 per cent when IOC was used selectively (odds ratio 1.43, 95 per cent c.i. 1.22 to 1.67). The model analysis estimated that seven injuries were avoided annually by routine IOC in Sweden, a population of 10 million. Over a 10-year period, 33 QALYs would be gained at an approximate net cost of (sic)808 000 , at a cost per QALY of about (sic)24 900. Conclusion: Routine IOC during cholecystectomy reduces the risk of BDI compared with the selective strategy and is a potentially cost-effective intervention.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Keyword
- quality-of-life
- cost-effectiveness analysis
- laparoscopic
- cholecystectomy
- operative cholangiography
- impact
- risk
- complications
- management
- survival
- repair
- Surgery
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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Rystedt, J. M.L.
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Wiss, J.
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Adolfsson, J.
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Enochsson, Lars
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Hallerback, B.
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Johansson, Pia, ...
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show more...
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Jönsson, Claes
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Leander, P.
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Osterberg, J.
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Montgomery, A.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Health Care Serv ...
- Articles in the publication
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BJS open
- By the university
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University of Gothenburg
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Umeå University
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Halmstad University
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Lund University
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Karolinska Institutet