FRIDAY, June 4 (HealthDay News) -- In elderly patients, prompt
removal of a suddenly inflamed gallbladder improves survival and
reduces costs and complications, new research shows.
In the study, Dr. Taylor S. Riall, associate professor of
surgery at the University of Texas Medical Branch in Galveston, and
colleagues analyzed data on 29,818 Medicare beneficiaries
hospitalized for a first episode of sudden inflammation of the
gallbladder (acute cholecystitis). While 75 percent of the patients
underwent surgical removal of the gallbladder (cholecystectomy),
one-quarter did not.
The in-hospital death rate for the patients who didn't undergo
cholecystectomy was 2.7 percent, compared with 2.1 percent for the
patients who had the surgery, the researchers found.
The study also found that 38 percent of patients who didn't have
their gallbladder removed had to be readmitted to hospital for
treatment of gallstones within the next two years, compared with 4
percent of patients who underwent gallbladder removal. Those
readmissions led to an average additional $14,000 in total charges
and more than $7,000 in Medicare payments per readmission.
Among the other findings:
- Twenty-seven percent of patients who didn't have their
gallbladder removed during their initial hospital stay required
subsequent gallbladder removal.
- Patients who didn't undergo gallbladder removal during initial
hospitalization were 56 percent more likely to die within two years
than those who underwent gallbladder removal.
"This is the first systematic study on how adherence to the recommendations for management of acute cholecystitis affects long-term outcomes and resource use," Riall said in a news release. "Our study helped identify both patients who are at high risk for not receiving definitive surgical treatment with cholecystectomy and those that are at high risk for being readmitted if they do not have cholecystectomy."
The study was published in the May issue of the
Journal of the American College of Surgeons.
More information
The U.S. National Library of Medicine has more about
acute cholecystitis.