| Summary: | 碩士 === 高雄醫學大學 === 藥學研究所碩士班 === 94 === Background：With the effects of westernized foods and life style, our countrymen’s prevalence of gallstones had become higher. Thus gallstone disease had become more common and been a risk to affect the thealth of our countrymen. Cholecystectomy is the main way to treat gallstone disease, fitting all type of gallstones.
Objectives：This research study the medical situation of cholecystectomy through health insurance database, to understand the the treatment of gallstone disease and study the medical utility of cholecystectomy.
Methods：This research is belong to retrospective study. The data resource is from health insurance database, and the 7712 case conditions was applied for cholecystectomy during 2002 January to 2004 June in south Taiwan. Then we divided the patients into three parts according to the operations, as laparoscopic cholecystectomy, laparoscopic convert open cholecystectomy and open cholecystectomy. And we compared and analyzed the diagnosis, comorbidity index, length of stay, and medical costs according as the medical treatment records.
Results：Acute cholelithiasis notably affect the direct medical costs of the patients with laparoscopic cholecystectomy. For the patients with laparoscopic cholecystectomy, the direct medical costs are lower relatively before the symptom of acute cholelithiasis. Once the patients have acute cholelithiasis, their operation is easily converted into open cholecystectomy. Thus the patients having laparoscopic cholecystectomy in the phase of non-acute cholelithiasis can reduce the direct medical costs and hospital stay.
Conclusion：Symptomatic gallstone disease that combined with acute cholelithiasis may cause anatomic situation become unclear. Then reduce the strike-rate of laparoscopic cholecystectomy and cause more complications. Thus some patients have to convert into open cholecystectomy and increase the medical costs and hospital stay. So the physicians of European and U.S.A. suggest those patients accept laparoscopic cholecystectomy as soon as possible.
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