Effects of additional laparoscopic cholecystectomy on outcomes of laparoscopic gastrectomy in patients with gastric cancer based on a national administrative database

详细信息    查看全文

• 作者：Atsuhiko Murata ; Kohji Okamoto ; Keiji Muramatsu ; Tatsuhiko Kubo ; Yoshihisa Fujino ; Shinya Matsuda
• 关键词：Gastric cancer ; Gallbladder stones ; Laparoscopic gastrectomy ; Laparoscopic cholecystectomy ; Outcomes ; Administrative database
• 刊名：Journal of Surgical Research
• 出版年：January, 2014
• 年：2014
• 卷：186
• 期：1
• 页码：157-163
• 全文大小：215 K

文摘

Background

Little information is available on the effects of adding laparoscopic cholecystectomy to laparoscopic gastrectomy on outcomes of patients with gastric cancer. The aim of this study is to investigate the effects of adding laparoscopic cholecystectomy to laparoscopic gastrectomy on outcomes in patients with gastric cancer using a national administrative database.

Methods

A total of 14,006 patients treated with laparoscopic gastrectomy for gastric cancer were referred to 744 hospitals in Japan between 2009 and 2011. Patients were divided into two groups, those who also underwent simultaneous laparoscopic cholecystectomy for gallbladder stones (n聽=聽1484) and those who underwent laparoscopic gastrectomy alone (n聽=聽12,522). Laparoscopy-related complications, in-hospital mortality, length of stay, and medical costs during hospitalization were compared in the patient groups.

Results

Multiple logistic regression analysis revealed that adding laparoscopic cholecystectomy did not affect laparoscopy-related complications (odds ratio, 1.02; 95% confidence interval [CI], 0.84-1.24; P聽=聽0.788) or in-hospital mortality (odds ratio, 1.16; 95% CI, 0.49-2.76; P聽=聽0.727). Multiple linear regression analysis also showed that adding laparoscopic cholecystectomy did not affect the length of stay (unstandardized coefficient, 0.37聽d; 95% CI, 鈭?.47 to 1.22聽d; P聽=聽0.389). However, adding laparoscopic cholecystectomy was associated with significantly increased medical costs during hospitalization (unstandardized coefficient, $1256.0 (95% CI, $806.2-$1705.9; P聽<聽0.001).

Conclusions

This study demonstrated that adding laparoscopic cholecystectomy did not affect outcomes of patients undergoing laparoscopic gastrectomy for gastric cancer, although medical costs during hospitalization were significantly increased.