International Journal for Quality in Health Care 5:81-85 (1993)
© 1993 International Society for Quality in Health Care
The Agreed Indications and Contra-indications for Cholecystectomy
Department of Gastroenterology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University Beer-Sheba, Israel
* Epidemiology Unit, Faculty of Health Sciences, Ben-Gurion University Beer-Sheba, Israel
Computational and Statistical Unit Hope Hospital, Salford, UK
Value Health Sciences Santa Monica, California, USA
Department of Medicine, UCLA Center for the Health Sciences and the RAND Corporation Santa Monica, California, USA
Indications as to which patients should undergo cholecystectomy remain, at least in part, a matter of controversy. In 1987, a panel of nine Israeli physicians from different specialties established a list of indications for the performance of cholecystectomy based on the literature available at the time. The panel agreed that cholecystectomy was appropriate for 59 indications and that it was inappropriate for 58. The major indications for surgery were biliary colic and acute cholecystitis. Patients who were asymptomatic or had vague symptoms were not recommended to undergo surgery unless they had stones in the common bile duct and were less than 71 years of age. Patients with pancreatitis were recommended for surgery if they had stones in the common bile duct and did not have a history of alcohol abuse. Performing a cholecystectomy at the same time as abdominal surgery was being performed for other reasons was indicated only if the patient was symptomatic from his gall-stones.
Keywords: Cholecystectomy, panel, appropriate, inappropriate, consensus agreement, comorbidity, score, indication, contra-indication
Dr G. M. Fraser, Dept of Gastroenterology, Soroka Medical Center, POB 151, Beer-Sheba, Israel.
Received for publication May 4, 1992. Accepted for publication July 15, 1992.