Back to Annual Meeting Posters

Background:
Cholecystectomy (laparoscopic or open) is one of the most frequent operations performed by general surgeons. Since the complication rate is low it has been difficult to evaluate the effects of different treatment strategies on the outcome due to lack of statistical power. This is in contrast to major surgery like in pancreatic or esophageal cancer where high complication rates make it easier to analyze the effects of major treatment changes. The Swedish Registry of Gallstone Surgery and ERCP (GallRiks) started in 2005 in order to be able to monitor the effect of different treatment strategies on the outcome. The aim of this paper is to present the impact that data from the registry has had in changing treatment strategies in cholecystectomy in Sweden.
Methods:
GallRiks is Supported by The National Board of Health and Welfare and The Swedish Surgical Society. There are approximately 60,000 cholecystectomies and 40,000 ERCP registered in the database during the period 2005-2011. Data are validated at every hospital in Sweden every third year to ensure good data quality. Each hospital has access to online reports where the outcome of their cholecystectomies and ERCP is compared with Sweden as a whole. The compliance of the registry in Sweden is good (>85%).
Results:
This validated database has led to the initiation of many research projects. The results are published in peer-reviewed scientific journals as well as presented at local meetings for users and general presentations at the annual Swedish surgical week. The findings appear to have an impact on treatment strategies. Thus,the use of antibiotic prophylaxis decreased in Sweden from 23 % to 14 % after the publication of Lundström(2) that showed this to be ineffective in elective cholecystectomy. The administration of thromboembolic prophylaxis has decreased by 18% after presentation of a study by Persson (4) proving this to increase bleeding complications in laparoscopic cholecystectomy.
Conclusions:
A transparent validated national registry with good compliance is a valuable tool to analyze and improve treatment strategies in benign surgery with low complication rates.
REFERENCES
1. Enochsson L et al.
Gastrointestinal endoscopy 2010;72(6): 1175-1184, 1184 e1171-1173.
2. Lundstrom P et al.
Journal of gastrointestinal surgery 2010;14(2): 329-334.
3. Palsson SH et al.
ISRN gastroenterology 2011;2011: 507389.
4. Persson G et al.
The British journal of surgery 2012;99(7): 979-986.
5. Tornqvist B et al.
BMJ 2012;345: e6457.