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Treatment of Symptomatic Cholelithiasis in France: A Decision Analysis Comparing Cholecystectomy and Biliary Lithotripsy

Published online by Cambridge University Press:  10 March 2009

A. Mark Fendrick ,
Gérard De Pouvourville ,
Caterine Bitker  and
Gilles Pelletier
A. Mark Fendrick
Affiliation:
École Polytechnique and Assistance, Publique—Hôpitaux de Paris
Gérard De Pouvourville
Affiliation:
École Polytechnique
Caterine Bitker
Affiliation:
Assistance Publique — Hôpitaux de Paris
Gilles Pelletier
Affiliation:
Assistance Publique — Hôpitaux de Paris
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Abstract

To determine the potential role of extracorporeal shock wave lithotripsy (ESWL) in the treatment of symptomatic gallstone patients in France, a simulation model evaluated the health and economic effects of three different treatment strategies. Decision analysis of conventional cholecystectomy alone and either of two strategies using a combination of biliary lithotripsy and conventional cholecystectomy reveals that a strategy employing biliary ESWL results in a significant number of successfully treated patients, thus avoiding the risks and costs of abdominal surgery. Moreover, cost analysis shows that expanding the use of lithotripsy to all patients for whom the procedure is indicated increases the average cost per successfully treated patient, but, more importantly, decreases the overall costs incurred by the cohort. From a societal viewpoint, a policy using biliary ESWL in appropriate patients is superior to one of cholecystectomy alone, from both clinical and economic perspectives.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 8 , Issue 1 , Winter 1992 , pp. 166 - 184
Copyright
Copyright © Cambridge University Press 1992

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References

1.Allen, M. J., Borody, T. J., May, G. R., et al. Rapid dissolution of gallstones in humans using methyl tert-butyl ether. New England Journal of Medicine, 1985, 312, 217–20.Google Scholar
2.Barkun, A. N. G., & Ponchon, T.Extracorporeal biliary lithotripsy. Review of experimental studies and a clinical update. Annals of Internal Medicine, 1990, 112, 126–37.Google Scholar
3.Brink, J. A., Simeone, J. F., Mueller, P., et al. Physical characteristics of gallstones removed at cholecystectomy: Implications for extracorporeal shock-wave lithotripsy. American Journal of Radiology, 1990, 151, 927–31.Google Scholar
4.Burhenne, H. J., Becker, C. D., Malone, D. E., et al. Biliary lithotripsy: Early observations in 106 patients. Radiology, 1989, 171, 363–67.Google Scholar
5.Burnett, D., Ertan, A., Jones, R., et al. Use of external shock-wave lithotripsy and adjuvant ursodiol for treatment of radiolucent gallstones. Digestive Disease Science, 1989, 34,1011–15.CrossRefGoogle ScholarPubMed
6.Chaussy, C.Extracorporeal shock wave lithotripsy: New aspects in the treatment of kidney stone disease. Basel, Switzerland: Karger, 1982.CrossRefGoogle Scholar
7.Chigot, J. P.Le risque opératoire dans la lithiase biliare. A propos de 5,433 interventions. Seminaire Hôpitaux Paris, 1981, 57, 1311–19.Google Scholar
8.Dictionnaire Vidal, 66th ed.Paris: 1990.Google Scholar
9.Doyle, P. J., Ward-McQuaid, J. N., & McEwen-Smith, A.The value of routine peroperative cholangiography: A Report of 4000 cholecystectomies. British Journal of Surgery, 1982, 69, 617–19.CrossRefGoogle ScholarPubMed
10.Dubois, F., Icard, P., Berthelod, G., & Levard, H.Coelioscopic cholecystectomy. Preliminary report of 36 cases. Annals of Surgery, 1990, 211, 60–62.CrossRefGoogle ScholarPubMed
11.Ell, C, Kerzel, W., Schneider, H. T., et al. Piezoelectric lithotripsy: Stone disintegration and follow-up results in patients with symptomatic gallbladder stones. Gastroenterology, 1990, 99, 1439–44.CrossRefGoogle ScholarPubMed
12.Fiches synthetiques par pathologies. Enquête de morbidité hospitalière — 1985–1987. Service des statistiques. Document statistiques number 89; ISSN 0997–4733: 05 1990.Google Scholar
13.Friedman, G. D., Paviola, C. A., & Fireman, B.Prognosis of gallstones with mild or no symptoms: 25 years of follow-up in a health maintenance organization. Journal of Clinical Epidemiology, 1989, 42, 127–36.Google Scholar
14.Fromm, H.Gallstone dissolution therapy. Current status and future prospects. Gastroenterology, 1986, 91, 1560–67.CrossRefGoogle ScholarPubMed
15.Ganey, J. B., Johnson, P. A., Prillaman, P. E., & McSwain, G. R.Cholecystectomy: Clinical experience with a large series. American Journal of Surgery, 1986, 151, 353–57.Google Scholar
16.Gordon, S. J., Stampfl, D., & Taglienti, G.Experience with gallbladder lithotripsy in 100 patients: Factors predicting outcome (abstract). Hepatology, 1990, 12, 868.Google Scholar
17.Gracie, W. A., & Ransohoff, D. F.The natural history of silent gallstones. The innocent gallstone is not a myth. New England Journal of Medicine, 1982, 307, 798–800.Google Scholar
18.Greiner, L., Wenzel, H., & Jakobeit, C.Biliary shock wave lithotripsy. Fragmentation and lysis — A new procedure. Deutschen Medicine Wochenschrift, 1987, 112, 1893–96.Google Scholar
19.Halpert, B.Carl Langenbuch: Master surgeon of the biliary system. Archives of Surgery, 1935, 25, 178–82.Google Scholar
20.Herberer, G., Paumgartner, G., Sauerbruch, T.A retrospective analysis of 3 year’s experience of an interdisciplinary approach to gallstone disease including shock waves. Annals of Surgery, 1988, 208, 274–78.Google Scholar
21Hermann, R. E.The spectrum of biliary stone disease. American Journal of Surgery, 1989, 158, 171–73.Google Scholar
22.Higuchi, W. I., Sjuib, F., Mufson, D., et al. Dissolution kinetics of gallstones. Physical model approach. Journal of Pharmacological Science, 1973, 62, 942–45.CrossRefGoogle ScholarPubMed
23.Hofmann, A. F.Medical dissolution of gallstones by oral bile acid therapy. American Journal of Surgery, 1989, 158, 198–204.Google Scholar
24.Hood, K. A., Keightley, A., Dowling, R. H., et al. Piezoelectric lithotripsy of gallbladder stones: Initial experience in 38 patients. Lancet, 1988, i, 1322–24.Google Scholar
25.Javitt, N. B.Lithotripsy: A medical cholecystectomy. Hospital Practice (office), 1988, 15, 10–11.CrossRefGoogle Scholar
26.Keane, F. B. V., & Tanner, W. A.Extracorporeal lithoptripsy for gallstones. British Journal of Surgery, 1988, 75, 506–07.Google Scholar
27.Kellett, M. J., Wickham, J. E. A., & Russell, R. C. G.Percutaneous cholecystolithotomy. British Medical Journal, 1988, 296, 453–55.CrossRefGoogle ScholarPubMed
28.Lanzini, A., Jazrawi, R. P., Kupfer, R. M., et al. Gallstone recurrence after medical dissolution. An overestimated threat? Journal of Hepatology, 1986, 3, 241–46.CrossRefGoogle ScholarPubMed
29. La situation demographique en 1986: Mouvement de la population. Institute national de la statistique et des etudes economiques. Document des collections de 1’INSEE number 578, serie D; ISSN 0533–0807; 04 1988, 121.Google Scholar
30.Marks, J. W., & Lan, S. P.The Steering Committee, The National Cooperative Gallstone Study Group. Low-dose chenodiol to prevent gallstone recurrence after dissolution therapy. Annals of Internal Medicine, 1984, 100, 376–81.CrossRefGoogle Scholar
31.McSherry, C. K.Cholecystectomy: The gold standard. American Journal of Surgery, 1989, 158, 174–78.CrossRefGoogle ScholarPubMed
32.McSherry, C. K., Ferstenberg, H., Calhoun, W. F., et al. The natural history of diagnosed gallstone disease in symptomatic and asymptomatic adults. Annals of Surgery, 1985, 202, 59–63.CrossRefGoogle Scholar
33.Miller, T. A.Laparoscopic cholecystectomy: Passing fancy or legitimate treatment option? Gastroenterology, 1990, 99, 1527–29.Google Scholar
34.Mosnier, H., Guivarch, M., Voinchet, O., et al. Lithotritie extracorporelle pour lithiase vesiculaire. Gastroenterology Clinical Biology, 1989, 13, 482–88.Google Scholar
35. National Hospital Survey. Traitment en GHM: De las base se données nationales. 20 05 1987.Google Scholar
36.Neubrand, M., Sauerbruch, T., Sellaard, F., & Paumgartner, G.In vitro cholesterol gallstone dissolution after fragmentation with shock waves. Digestion, 1986, 34, 51–59.CrossRefGoogle ScholarPubMed
37.O’Donnell, L. D. J., & Heaton, K. W.Recurrence and re-recurrence of gall stones after medical dissolution: A longterm follow up. Gut, 1988, 29, 655–58.Google Scholar
38.Pauwels, W., Afschrift, M., De Wilde, V., et al. Extracorporeal shock-wave lithotripsy for partly calcified gallbladder stones (abstract). Gastroenterology, 1990, 98, A619.Google Scholar
39.Pauwels, W., De Wilde, V.Afschrift, M., et al. Extracorporeal shock-wave lithotripsy for radiolucent gallbladder stones (abstract). Gastroenterology, 1990, 98, A620.Google Scholar
40.Peine, C. J., Petersen, B. T., Williams, H. J., et al. Extracorporeal shock-wave lithotripsy and methyl tert-butyl ether for partially calcified gallstones. Gastroenterology, 1989, 97, 1229–35.CrossRefGoogle ScholarPubMed
41.Pelletier, G., Capdeville, R., Mosnier, H., et al. Low gallstone recurrence rate after suc cessful lithotripsy in patients with solitary stones (abstract). Hepatology, 1990, 12, 869.Google Scholar
42.Pelletier, G., Delmont, J., Capdeville, R., et al. Treatment of gallstones with piezoelectric lithotripsy and oral bile acids, a multicenter study. Journal of Hepatology, in press.Google Scholar
43.Perissat, J., Collet, D. R., & Belliard, R.Gallstones: Laparoscopic treatment, intracorporeal lithotripsy followed by cholecystotomy or cholecystectomy—A personal technique. Endoscopy, 1989, 21, 373–74.CrossRefGoogle ScholarPubMed
44.Pickleman, J.Controversies in biliary tract surgery. Canadian Journal of Surgery, 1986, 29, 429–33.Google Scholar
45.Podda, M., Zuin, M., Battezzati, P. M., et al. Efficacy and safety of a combination of chenodeoxycholic acid and ursodeoxycholic acid for gallstone dissolution: A comparison with ursodeoxycholic acid alone. Gastroenterology, 1989, 96, 222–29.CrossRefGoogle ScholarPubMed
46.Ponchon, T., Barkun, A. N., Pujol, B., et al. Gallstone disappearance after extracorporeal lithotripsy and oral bile acid dissolution. Gastroenterology, 1989, 97, 457–63.CrossRefGoogle ScholarPubMed
47.Ransohoff, D. E., Grade, W. A., Wolfenson, L. B., & Neuhauser, D.Prophylactic cholecystectomy or expectant management for silent gallstones. Annals of Internal Medicine, 1983, 29, 199–204.Google Scholar
48.Reddick, E. J., & Olsen, D. O.Laparoscopic laser cholecystectomy: A comparison with mini-lap cholecystectomy. Surgical Endoscopy, 1989, 3, 131–33.CrossRefGoogle ScholarPubMed
49.Sackmann, M., Delius, M., Sauerbruch, T., et al. Shock-wave lithotripsy of gallbladder stones. The first 175 patients. New England Journal of Medicine, 1988, 318, 393–97.Google Scholar
50.Sackmann, M., Ippisch, E., Sauerbruch, T., et al. Early gallstone recurrence rate after successful shock-wave therapy. Gastroenterology, 1990, 98, 392–96.Google Scholar
51.Sackmann, M., Pauletzku, J., Aydemir, U., et al. Monotherapy with ursodeoxycholic acid is as efficient as a combination or urso- and chenodeoxycholic acid for the dissolution of gallstone fragments (abstract). Hepatology, 1990, 12, 869.Google Scholar
52.Sandier, R. S., Maule, W. F., Baltus, M. E., et al. Biliary tract surgery in the elderly. Journal of General Internal Medicine, 1987, 2, 149–54.CrossRefGoogle Scholar
53.Sauerbruch, T., Delius, M., Paumgartner, G., et al. Fragmentation of gallstones by extracorporeal shock waves. New England Journal of Medicine, 1986, 314, 818–22.Google Scholar
54.Sauerbruch, T., & Stern, M.Fragmentation of bile duct stones by extracorporeal shock waves. Gastroenterology, 1989, 96, 146–52.Google Scholar
55.Schoenfield, L. J., & the Dornier National Biliary Lithotripsy Study. The effect of ursodiol on the efficacy and safety of extracorporeal shock-wave lithotripsy of gallstones. New England Journal of Medicine, 1990, 323, 1239–45.Google Scholar
56.Schoenfield, L. J., Carulli, N., Dowling, R. H., et al. Asymptomatic gallstones: Definition and treatment. Gastroenterology International, 1989, 1, 25–29.Google Scholar
57. Science and Vie economic Magazine, hors serie 1990, 22.Google Scholar
58.Sleisenger, M. H., & Fordtran, J. S. (eds.). Gastrointestinal disease: Pathophysiology, diagnosis, management, 4th ed.Philadelphia, PA: W. B. Saunders, 1989.Google Scholar
59. Statistiques d'activité et prix de revient de l'année 1989. Livre II: Prix de revient des sections d’hospitalisation. Direction des finances; ISSN 0984–6433.Google Scholar
60.Thistle, J. L.Postdissolution gallstone recurrence. Digestive Disease Science, 1989, 34(suppl.), 44S–48S.CrossRefGoogle ScholarPubMed
61.Thistle, J. L., Cleary, P. A., Lachin, J. M., et al. The natural history of cholelithiasis: The National Cooperative Gallstone Study. Annals of Internal Medicine, 1984, 101, 171–75.Google Scholar
62.Thistle, J. L., & Peterson, B. T., Biliary lithotripsy: A perspective. Annals of Internal Medicine, 1989, 111, 868–70.Google Scholar
63.Vanderpool, D., Jones, R. C, O'Leary, P., & Hamilton, J. K.Biliary lithotripsy. American Journal of Surgery, 1989, 158, 194–97.Google Scholar
64.Villanova, N., Bazzoli, F., Taroni, F., et al. Gallstone recurrence after successful oral bile acid treatment: A 12-year follow-up and evaluation of long-term postdissolution treatment. Gastroenterology, 1989, 97, 726–31.Google Scholar
65.Way, L. W.Changing therapy for gallstone disease. New England Journal of Medicine, 1990, 323, 1273–74.Google Scholar
66.Weinstein, D. F., Brink, J. A., & Richter, J. M.Nonsurgical treatment of cholelithiasis: An analysis of clinical opportunity. International Journal of Technology Assessment in Health Care, 1990, 6, 643–54.CrossRefGoogle ScholarPubMed
67.Weinstein, M. C., Coley, C. M., & Richter, J. M.Medical management of gallstones: A cost-effectiveness analysis. Journal of General Internal Medicine, 1990, 5, 277–84.Google Scholar
68.Weinstein, M. C., Fineberg, H. V., Elstein, A. S., et al. Clinical decision analysis. Philadelphia, PA: W. B. Saunders, 1980.Google Scholar