PubMed · 1421535
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J V White. 1992. Consensus on laparoscopic surgery.. https://pubmed.ncbi.nlm.nih.gov/1421535/
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Lifetime risk of gallstones in Australia is 14%-20%. The most common symptom of gallstones in either the gallbladder or bile duct is epigastric to right upper quadrant pain. Cholecystectomy is indicated for symptomatic gallbladder stones and is usually performed laparoscopically; surgery is rarely indicated for asymptomatic stones. Endoscopic retrograde cholangiopancreatography is indicated for complications of bile duct stones, such as jaundice, cholangitis or severe pancreatitis, and for postcholecystectomy symptoms of stones; bile duct stones may be removed in the same procedure via endoscopic sphincterotomy. Bile duct stones are mostly diagnosed by operative cholangiography at cholecystectomy. Open surgery is used when minimal-access techniques are dangerous, unsuitable or impossible.
AIM: To compare two priority access criteria scoring methods for elective cholecystectomy, with a score based on clinical judgement obtained using a linear analogue scale. METHODS: Patients placed on the waiting list for elective laparoscopic cholecystectomy between June and October 1997 were prioritised using the three methods. RESULTS: Data were obtained for 22 patients. The distributions of scores were different but there was a significant correlation between them. However, limits of agreement analysis demonstrated little agreement between them with a difference of +/- 30 points (out of a 100) between scores obtained with each method. CONCLUSION: The proposed methods for establishing priority access to elective cholecystectomy are poor tools, require validation and bear little relation to expert clinical judgement.
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