Katie M Wells1, Yu-Jin Lee2, Sandag Erdene3, Sarnai Erdene3, Urjin Sanchin4, Orgoi Sergelen3, Chong Zhang5, Brandon P Rodriguez6, Catherine R deVries6, Raymond R Price7. 1. The University of Utah Center for Global Surgery, Salt Lake City, UT; The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. 2. Stanford University School of Medicine, Stanford, CA. 3. Mongolia Health Sciences University and First Central Hospital Mongolia, Ulaanbaatar, Mongolia. 4. Second General Hospital Mongolia, Ulaanbaatar, Mongolia. 5. Department of Internal Medicine and Epidemiology, Salt Lake City, UT. 6. The University of Utah Center for Global Surgery, Salt Lake City, UT. 7. The University of Utah Center for Global Surgery and Intermountain Healthcare, Salt Lake City, UT. Electronic address: rayrprice@comcast.net.
Abstract
BACKGROUND: The benefits of laparoscopic cholecystectomy, including rapid recovery and fewer infections, have been largely unavailable to the majority of people in developing countries. Compared to other countries, Mongolia has an extremely high incidence of gallbladder disease. In 2005, only 2% of cholecystectomies were performed laparoscopically. This is a retrospective review of the transition from open to laparoscopic cholecystectomy throughout Mongolia. METHODS: A cross-sectional, retrospective review was conducted of demographic patient data, diagnosis type, and operation performed (laparoscopic versus open cholecystectomy) from 2005-2013. Trends were analyzed from 6 of the 21 provinces (aimags) throughout Mongolia, and data were culled from 7 regional diagnostic referral and treatment centers and 2 tertiary academic medical centers. The data were analyzed by individual training center and by year before being compared between rural and urban centers. RESULTS: We analyzed and compared 14,522 cholecystectomies (n = 4,086 [28%] men, n = 10,436 [72%] women). Men and women were similar in age (men 52.2, standard deviation 14.8; women 49.4, standard deviation 15.7) and in the percentage undergoing laparoscopic cholecystectomy (men 39%, women 42%). By 2013, 58% of gallbladders were removed laparoscopically countrywide compared with only 2% in 2005. In 2011, laparoscopic cholecystectomy surpassed open cholecystectomy as the primary method for gallbladder removal countrywide. More than 315 Mongolian health care practitioners received laparoscopic training in 19 of the country's 21 aimags (states). CONCLUSION: By 2013, 58% of cholecystectomies countrywide were performed laparoscopically, a dramatic increase over 9 years. The expansion of laparoscopic cholecystectomy has transformed the care of biliary tract disease in Mongolia despite the country's limited resources.
BACKGROUND: The benefits of laparoscopic cholecystectomy, including rapid recovery and fewer infections, have been largely unavailable to the majority of people in developing countries. Compared to other countries, Mongolia has an extremely high incidence of gallbladder disease. In 2005, only 2% of cholecystectomies were performed laparoscopically. This is a retrospective review of the transition from open to laparoscopic cholecystectomy throughout Mongolia. METHODS: A cross-sectional, retrospective review was conducted of demographic patient data, diagnosis type, and operation performed (laparoscopic versus open cholecystectomy) from 2005-2013. Trends were analyzed from 6 of the 21 provinces (aimags) throughout Mongolia, and data were culled from 7 regional diagnostic referral and treatment centers and 2 tertiary academic medical centers. The data were analyzed by individual training center and by year before being compared between rural and urban centers. RESULTS: We analyzed and compared 14,522 cholecystectomies (n = 4,086 [28%] men, n = 10,436 [72%] women). Men and women were similar in age (men 52.2, standard deviation 14.8; women 49.4, standard deviation 15.7) and in the percentage undergoing laparoscopic cholecystectomy (men 39%, women 42%). By 2013, 58% of gallbladders were removed laparoscopically countrywide compared with only 2% in 2005. In 2011, laparoscopic cholecystectomy surpassed open cholecystectomy as the primary method for gallbladder removal countrywide. More than 315 Mongolian health care practitioners received laparoscopic training in 19 of the country's 21 aimags (states). CONCLUSION: By 2013, 58% of cholecystectomies countrywide were performed laparoscopically, a dramatic increase over 9 years. The expansion of laparoscopic cholecystectomy has transformed the care of biliary tract disease in Mongolia despite the country's limited resources.
Authors: Jade M Nunez; Jonathan Nellermoe; Andrea Davis; Simon Ruhnke; Battsetseg Gonchigjav; Nomindari Bat-Erdene; Anudari Zorigtbaatar; Ali Jalali; Kevin Bagley; Micah Katz; Hannah Pioli; Batsaikhan Bat-Erdene; Sarnai Erdene; Sergelen Orgoi; Raymond R Price; Ganbold Lundeg Journal: BMJ Open Date: 2022-07-21 Impact factor: 3.006
Authors: Mee Joo Kang; Kwabena Breku Apea-Kubi; Kojo Assoku Kwarko Apea-Kubi; Nyabenda-Gomwa Adoula; James Nii Noi Odonkor; Alfred Korbia Ogoe Journal: Ann Glob Health Date: 2020-07-30 Impact factor: 2.462