Variation in the Use of Laparoscopic Cholecystectomy for Acute Cholecystitis: a Population-based Study

Hypothesis: There is wide variation in the use of laparoscopic cholecystectomy (LC) for acute cholecystitis among all public hospitals in Hong Kong. The objective of this study was to determine the factors responsible for the use of LC for acute cholecystitis in a stable population.

Design: A retrospective survey on 2353 patients with pathologically proven acute cholecystitis treated with cholecystectomy in Hong Kong from 1998 to 2002.

Setting: All public hospitals in Hong Kong.

Results: The rate of using LC for acute cholecystitis increased by 30.4% from 1998 to 2002. We observed a wide variation in the use of LC for acute cholecystitis ranging from 3.7% to 92.9% (P<.001). There was no correlation between the number of cholecystectomies performed and the percentage of LCs performed in each hospital (P = .39). Logistic regression analysis showed that the hospital, year of operation, and age of the patients were independent variables for LC.

Conclusions: A wide variation in the use of LC for acute cholecystitis was observed among the public hospitals in Hong Kong. Young female patients from selected hospitals recently are more likely to be treated with LC.