From Our 2010 Archives

Removing Gallbladder Sooner Cuts Costs, Readmissions

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% 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%, compared with 2.1% for the patients who had the surgery, the researchers found.

The study also found that 38% 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% 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% 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.

-- Robert Preidt

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SOURCE: American College of Surgeons, news release, June 1, 2010