Increased Cholecystectomy Rate After Introduction of Laparoscopic Cholecystectomy

To the Editor.  —We can confirm and supplement the findings of Legorreta et al¹ regarding the impact of the introduction of the laparoscopic technique for gallbladder surgery with data from the national capital area.Using the Pro/File information processing system and claim data from almost 1 million local Blue Cross and Blue Shield enrollees for the years 1989 to 1992, we analyzed the practice patterns of 7000 participating physicians and 36 area hospitals. Our study of gallbladder surgery quantified significant annual increases in the rate of surgery (from 0.80 procedure per 1000 adults in 1989 to 0.86 in 1990,1.13 in 1991, and 1.22 in 1992), or an increase of 52.4%. At the same time we identified an increasing share of the laparoscopic technique compared with the traditional technique (from 2.3% to 27.7% to 74.4% to 83.4%), along with a significant decline in overall average length of stay (from 5.8