Department of Radiology, Baptist Memorial Hospital, and The University of Tennessee Health Science Center, Memphis, Tennessee, USA.
J Am Coll Radiol. 2012 Jul;9(7):474-9. doi: 10.1016/j.jacr.2012.02.019.
The aim of this study was to assess national trends and regional variation in the utilization of percutaneous cholecystostomy (PC).
Medicare fee-for-service claims files from 1994 to 2009 were used to identify trends in PC compared with laparoscopic and open surgical gallbladder procedures. Volume, geographic variation, provider specialty, and service site were analyzed.
Between 1994 and 2009, annual PC procedures increased by 567% (from 1,085 to 7,239). Laparoscopic cholecystectomy increased by 3% (from 203,836 to 209,650), and open procedures declined by 73% (from 119,086 to 32,222). As a percentage of all gallbladder procedures, PC increased from 0.3% to 2.9% and varied considerably among Medicare regions, ranging from 1.4% (Denver) to 5.2% (Boston). Radiologists perform most PC procedures (97%), and most are performed on hospital inpatients (92%).
Annual PC procedures on Medicare beneficiaries increased almost 6-fold in recent years, as laparoscopic cholecystectomy remained stable, and open procedures declined. The relative utilization of PC varies considerably by region across the United States.
本研究旨在评估经皮胆囊造口术（PC）的利用在全国范围内的趋势和地区差异。
本研究使用了 1994 年至 2009 年的 Medicare 按服务收费的索赔档案，以评估与腹腔镜和开放性胆囊手术相比，PC 的趋势。分析了数量、地理差异、提供者专业和服务地点。
1994 年至 2009 年间，每年的 PC 手术量增加了 567%（从 1085 例增加到 7239 例）。腹腔镜胆囊切除术增加了 3%（从 203836 例增加到 209650 例），而开放性手术减少了 73%（从 119086 例减少到 32222 例）。作为所有胆囊手术的百分比，PC 从 0.3%增加到 2.9%，并且在 Medicare 地区之间差异很大，范围从 1.4%（丹佛）到 5.2%（波士顿）。放射科医生进行了大多数 PC 手术（97%），并且大多数是在医院住院病人中进行的（92%）。
近年来，接受 Medicare 福利的患者的年度 PC 手术增加了近 6 倍，而腹腔镜胆囊切除术保持稳定，开放性手术减少。PC 的相对利用在美国各地的地区差异很大。
