Insights from Global, National, and Local Studies of Benign Biliary Disease for 2023

Author:

Lunevicius Raimundas

Abstract

In the existing literature regarding benign gallbladder and bile duct diseases, there is an insufficient connection between biliary disease-specific descriptive epidemiology and clinical medicine, which are two distinct research areas. Global collaborative, national, single-centre and review studies of benign gallbladder and bile duct diseases and related surgical procedures were examined to gain insights into their highlighted trends, patterns, characteristics, comparisons and suggestions. A comparative analysis of the age-standardised prevalence and incidence of benign biliary diseases across 204 countries and territories changed the global narrative by indicating that they should not be stratified into Western and Eastern because the prevalence and incidence of these diseases mainly depend on the sociodemographic index (SDI) of the country instead of the geographical location or region. A high SDI does not always correspond to a high Healthcare Access and Quality (HAQ) index. Trends in the prevalence and incidence of benign biliary diseases are increasing. Age-standardised mortality rates increased by 25% between 1990 and 2020, and it was estimated that there was a 10% decrease in the total number of cholecystectomies from 2016 to 2019. Damage control and surgery limitations are gaining recognition in England, and this shift in gallbladder surgery has become apparent. A seven-fold increase in subtotal (or partial) cholecystectomies in England was estimated between 2000 and 2019. The trends in the application of tube cholecystostomy were similar. Cholecystolithotomy was performed for 1 of every 1250 patients. Bile duct injury rates are still correlated with high intraoperative difficulty. The suggested terms ‘subtotal open-tract cholecystectomy’ and ‘subtotal closed-tract cholecystectomy’ are distinct, mutually exclusive and consistent with the ideas connecting most works published during the past 124 years. Ethical considerations arising from direct long-term observations of biliary surgery practices and recent publications comprise a grey area of medical research. These insights have improved our understanding of benign gallbladder and bile duct diseases and how to prevent them; however, further evidence-based discussions are required. This work highlights the need to develop precision-based biliary medicine and surgery.

Publisher

IntechOpen

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