The Swedish Registry of Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks)

Enochsson, Lars; Thulin, Anders; Österberg, Johanna; Sandblom, Gabriel; Persson, Gunnar

doi:10.1001/jamasurg.2013.1221

Cited by 117 publications

(118 citation statements)

References 15 publications

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“…A decrease in open cholecystectomies combined with an increased use of laparoscopic technique in both elective and urgent settings, and lower LOS is also reported in the Swedish Database, GallRiks, were parameters were not predefined [4]. It is therefore difficult to deduct whether the construction of pre-set database goals or the general awareness on a procedure by constructing a database is the determining factor in improving results.…”

Section: Discussionmentioning

confidence: 99%

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The quality of cholecystectomy in Denmark has improved over 6-year period

Rothman

Burcharth

Pommergaard

et al. 2015

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 99%

“…For the last decade, increasing attention has been on improving the surgical quality after different procedures by the use of large databases [1][2][3][4][5]. One of these was the Danish Cholecystectomy Database (DCD), which started on January 1, 2006.…”

Section: Introductionmentioning

confidence: 99%

The quality of cholecystectomy in Denmark has improved over 6-year period

Rothman

Burcharth

Pommergaard

et al. 2015

Langenbecks Arch Surg

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“…In patients from endemic regions undergoing cholecystectomy, 3.5% of gallbladder tissues harbored the bacterium [13] while electron micrographic observation of gallstones retrieved from such individuals demonstrate bacterial biofilm formation on the gallstone surface (Figure 1). Gallstones are present in 5–10% of the human population and gallstone disease is quite widespread [16]. Although identification of non-salmonellae bacteria in gallbladder tissues of cholecystectomy patients is not uncommon [17], gallstones of such patients infected with other Enterobacteriaceae are not similarly covered in a bacterial biofilm [18].…”

Section: The Mechanisms Of Salmonella Persistence In the Gallbladdermentioning

confidence: 99%

Salmonella chronic carriage: epidemiology, diagnosis, and gallbladder persistence

Gunn

Marshall

Baker

et al. 2014

Trends in Microbiology

260

242

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Typhoid (enteric fever) remains a major cause of morbidity and mortality worldwide, causing over 21 million new infections annually, with the majority of deaths occurring in young children. As typhoid fever-causing Salmonella have no known environmental reservoir, the chronic, asymptomatic carrier state is thought to be a key feature of continued maintenance of the bacterium within human populations. In spite of the importance of this disease to public health, our understanding of the molecular mechanisms that catalyze carriage, as well as our ability to reliably identify and treat the Salmonella carrier state, have only recently begun to advance.

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“…Thus, they all concluded that prophylactic antibiotics are not needed or warranted for low-risk laparoscopic cholecystectomy. Consequently, a current report documented a trend of not using antibiotic prophylaxis in laparoscopic cholecystectomy [27]. However, most trials in these meta-analyses had a relatively small sample size and were considered to be statistically underpowered for the rare event of infections [28], [29].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Prophylaxis in Laparoscopic Cholecystectomy: A Randomized Controlled Trial

et al. 2014

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BackgroundRecent meta-analyses concluded that antibiotic prophylaxis is not warranted in low-risk laparoscopic cholecystectomy. However, most trials in the meta-analyses had a relatively small sample size and were statistically underpowered. In addition, many of the trials mentioned potential cost savings owing to the elimination of prophylactic antibiotics. However, no trial has statistically estimated the cost effectiveness. To evaluate the results of meta-analyses, we conducted a randomized controlled trial on the role of prophylactic antibiotics in low-risk laparoscopic cholecystectomy with an adequate sample size.MethodsFrom March 2007 to May 2013, at the Department of Surgery, Kansai Medical University, patients who were scheduled for elective laparoscopic cholecystectomy were randomly assigned to one of two arms: those who were and were not administered prophylactic antibiotics. The primary endpoint was the occurrence of postoperative infections and secondary endpoints were postoperative hospital stay and medical costs.FindingsDuring the study period, 518 patients were assigned to the Antibiotics group and 519 to the No antibiotics group. Occurrences of surgical site infections, distant infections and overall infections were significantly lower in the Antibiotics group than in the No antibiotics group (0.8 vs. 3.7%, p = 0.001, OR: 0.205 (95%CI: 0.069 to 0.606); 0.4 vs. 3.1%, p = 0.0004, OR: 0.122 (95%CI: 0.028 to 0.533); 1.2 vs. 6.7%; p<0.0001, OR: 0.162 (95%CI: 0.068 to 0.389), respectively). The postoperative hospital stay was significantly shorter in the Antibiotics group (mean, SD: 3.69±1.56 vs. 4.07±3.00; p = 0.01) and the postoperative medical costs were significantly lower in the Antibiotics group (mean, SD: $766±341 vs. 832±670; p = 0.047). Multivariable analysis showed that independent risk factors for postoperative infectious complications were no prophylactic antibiotics (p<0.0001) and age 65 or older (p = 0.006).ConclusionsPerioperative administration of prophylactic antibiotics should be recommended in laparoscopic cholecystectomy to prevent postoperative infectious complications and to reduce medical costs.Trial RegistrationUMIN Clinical Trials Registry UMIN000003749.

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The Swedish Registry of Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks)

Abstract: GallRiks is a validated national quality registry for gallstone surgery and ERCP, serving as a base for audit of gallstone disease treatment. It also provides a database for clinical research.

Cited by 117 publications

References 15 publications

The quality of cholecystectomy in Denmark has improved over 6-year period

The quality of cholecystectomy in Denmark has improved over 6-year period

Salmonella chronic carriage: epidemiology, diagnosis, and gallbladder persistence

Antibiotic Prophylaxis in Laparoscopic Cholecystectomy: A Randomized Controlled Trial

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