{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T08:21:12Z","timestamp":1772612472559,"version":"3.50.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2013,5,31]],"date-time":"2013-05-31T00:00:00Z","timestamp":1369958400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>During recent years laparoscopic cholecystectomy has dramatically increased, sometimes resulting in overtreatment. Aim of this work was to retrospectively analyze all laparoscopic cholecystectomies performed in a single center in order to find the percentage of patients whose surgical treatment may be explained with this general trend, and to speculate about the possible causes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>831 patients who underwent a laparoscopic cholecystectomy from 1999 to 2008 were retrospectively analyzed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>At discharge, 43.08% of patients were operated on because of at least one previous episode of biliary colic before the one at admission; 14.08% of patients presented with acute lithiasic cholecystitis; 14.68% were operated on because of an increase in bilirubin level; 1.56% were operated on because of a previous episode of jaundice with normal bilirubin at admission; 0.72% had gallbladder adenomas, 0.72% had cholangitis, 0.36% had biliodigestive fistula and one patient (0.12%) had acalculous cholecystitis. By excluding all these patients, 21.18% were operated on without indications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The broadening of indications for laparoscopic cholecystectomy is undisputed and can be considered a consequence of new technologies that have been introduced, increased demand from patients, and the need for practice by inexperienced surgeons. If not prevented, this trend could continue indefinitely.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2482-13-17","type":"journal-article","created":{"date-parts":[[2013,5,31]],"date-time":"2013-05-31T16:14:52Z","timestamp":1370016892000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Increased rate of cholecystectomies performed with doubtful or no indications after laparoscopy introduction: a single center experience"],"prefix":"10.1186","volume":"13","author":[{"given":"Elia","family":"Pulvirenti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Toro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Gagner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Mannino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isidoro","family":"Di Carlo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2013,5,31]]},"reference":[{"key":"298_CR1","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1007\/s10620-006-9107-3","volume":"52","author":"GH Sakorafas","year":"2007","unstructured":"Sakorafas GH, Milingos D, Peros G: Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci. 2007, 52: 1313-1325. 10.1007\/s10620-006-9107-3.","journal-title":"Dig Dis Sci"},{"key":"298_CR2","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1002\/bjs.4547","volume":"91","author":"I Halldestam","year":"2004","unstructured":"Halldestam I, Enell EL, Kullman E, BorchK : Development of symptoms and complications in individuals with asymptomatic gallstones. Br J Surg. 2004, 91: 734-738. 10.1002\/bjs.4547.","journal-title":"Br J Surg"},{"key":"298_CR3","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/j.gtc.2010.02.004","volume":"39","author":"KS Gurusamy","year":"2010","unstructured":"Gurusamy KS, Davidson BR: Surgical treatment of gallstones. Gastroenterol Clin North Am. 2010, 39: 229-244. 10.1016\/j.gtc.2010.02.004.","journal-title":"Gastroenterol Clin North Am"},{"key":"298_CR4","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1007\/BF02260323","volume":"19","author":"RP Nenner","year":"1994","unstructured":"Nenner RP, Imperato PJ, Rosenberg C, RonbergE : Increased cholecystectomy rates among Medicare patients after the introduction of laparoscopic cholecystectomy. J Community Health. 1994, 19: 409-415. 10.1007\/BF02260323.","journal-title":"J Community Health"},{"key":"298_CR5","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1097\/00129689-200310000-00005","volume":"13","author":"AK Aslar","year":"2003","unstructured":"Aslar AK, Ertan T, Oquz H, Gocmen E, KocM : Impact of laparoscopy on frequency of surgery for treatment of gallstones. Surg Laparosc Endosc Percutan Tech. 2003, 13: 315-317.","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"298_CR6","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1097\/00000658-199803000-00005","volume":"227","author":"JA Shea","year":"1998","unstructured":"Shea JA, Berlin JA, Bachwich DR, Staroscik RN, Malet PF, McGuckin M: Indications for and outcomes of cholecystectomy: a comparison of the pre and postlaparoscopic eras. Ann Surg. 1998, 227: 343-350. 10.1097\/00000658-199803000-00005.","journal-title":"Ann Surg"},{"key":"298_CR7","doi-asserted-by":"publisher","first-page":"2368","DOI":"10.1007\/s00464-010-1268-7","volume":"24","author":"DW Overby","year":"2010","unstructured":"Overby DW, Apelgren KN, Richardson W, Fanelli R, Society of American Gastrointestinal and Endoscopic Surgeons: SAGES guidelines for the clinical application of laparoscopic biliary tract surgery. Surg Endosc. 2010, 24: 2368-86. 10.1007\/s00464-010-1268-7.","journal-title":"Surg Endosc"},{"key":"298_CR8","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s00534-006-1161-x","volume":"14","author":"Y Yamashita","year":"2007","unstructured":"Yamashita Y, Takada T, Kawarada Y, Nimura Y, Hirota M, Miura F: Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007, 14: 91-97. 10.1007\/s00534-006-1161-x.","journal-title":"J Hepatobiliary Pancreat Surg"},{"key":"298_CR9","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1097\/00000658-199611000-00005","volume":"224","author":"JA Shea","year":"1996","unstructured":"Shea JA, Healey MJ, Berlin JA, Clarke JR, Malet PF, Staroscik RN: Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis. Ann Surg. 1996, 224: 609-620. 10.1097\/00000658-199611000-00005.","journal-title":"Ann Surg"},{"key":"298_CR10","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1007\/s004649900662","volume":"12","author":"EM Targarona","year":"1998","unstructured":"Targarona EM, Marco C, Balagu\u00e9 C, Rodriguez J, Cugat E, Hoyuela C: How, when, and why bile duct injury occurs. A comparison between open and laparoscopic cholecystectomy. Surg Endosc. 1998, 12: 322-326. 10.1007\/s004649900662.","journal-title":"Surg Endosc"},{"key":"298_CR11","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1007\/s00464-001-0008-4","volume":"15","author":"NA Kama","year":"2001","unstructured":"Kama NA, Doganay M, Dolapci M, Reis E, Atli M, Kologlu M: Risk factors resulting in conversion of laparoscopic cholecystectomy to open surgery. Surg Endosc. 2001, 15: 965-968. 10.1007\/s00464-001-0008-4.","journal-title":"Surg Endosc"},{"key":"298_CR12","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1056\/NEJM199402103300607","volume":"330","author":"CA Steiner","year":"1994","unstructured":"Steiner CA, Bass EB, Talamini MA, Pitt HA, Steinberg EP: Surgical rates and operative mortality for open and laparoscopic cholecystectomy in Maryland. N Engl J Med. 1994, 330: 403-408. 10.1056\/NEJM199402103300607.","journal-title":"N Engl J Med"},{"key":"298_CR13","doi-asserted-by":"publisher","first-page":"57","DOI":"10.4103\/1319-3767.32179","volume":"13","author":"KR Murshid","year":"2007","unstructured":"Murshid KR: Asymptomatic gallstones: should we operate?. Saudi J Gastroenterol. 2007, 13: 57-69. 10.4103\/1319-3767.32179.","journal-title":"Saudi J Gastroenterol"},{"key":"298_CR14","first-page":"243","volume":"41","author":"R Tritapepe","year":"1999","unstructured":"Tritapepe R, Piro D, Annoni F, Segala M: Predictive factors for cholelithiasis complications. Panminerva Med. 1999, 41: 243-246.","journal-title":"Panminerva Med"},{"key":"298_CR15","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/S0891-5520(20)30647-4","volume":"9","author":"TJ Babineau","year":"1995","unstructured":"Babineau TJ, Bothe A: General surgery considerations in the diabetic patient. Infect Dis Clin North Am. 1995, 9: 183-193.","journal-title":"Infect Dis Clin North Am"},{"key":"298_CR16","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1023\/A:1018897827285","volume":"43","author":"A Csendes","year":"1998","unstructured":"Csendes A, Smok G, Burdiles P, Csendes P, Burgos A, Recio M: Histological findings of gallbladder mucosa in 95 control subjects and 80 patients with asymptomaticgallstones. Dig Dis Sci. 1998, 43: 931-934. 10.1023\/A:1018897827285.","journal-title":"Dig Dis Sci"},{"key":"298_CR17","first-page":"10","volume":"27","author":"I Di Carlo","year":"2010","unstructured":"Di Carlo I, Toro A, Pulvirenti E, Zisa M, Galia A: An unusual association of diffuse adenomyomatosis with dysplastic adenoma in chronic calculous cholecystitis: case presentation. BMC Gastroenterol. 2010, 27: 10-41.","journal-title":"BMC Gastroenterol"},{"key":"298_CR18","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1007\/s11605-008-0748-8","volume":"13","author":"C Avgerinos","year":"2009","unstructured":"Avgerinos C, Kelgiorgi D, Touloumis Z, Baltatzi L, Dervenis C: One thousand laparoscopic cholecystectomies in a single surgical unit using the \u201ccritical view of safety\u201d technique. J Gastrointest Surg. 2009, 13: 498-503. 10.1007\/s11605-008-0748-8.","journal-title":"J Gastrointest Surg"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2482-13-17.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2482-13-17\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2482-13-17","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2482-13-17.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:09:17Z","timestamp":1630541357000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcsurg.biomedcentral.com\/articles\/10.1186\/1471-2482-13-17"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,31]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["298"],"URL":"https:\/\/doi.org\/10.1186\/1471-2482-13-17","relation":{},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5,31]]},"assertion":[{"value":"17 September 2012","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2013","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 May 2013","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"17"}}