Trends in Use of Upper Abdominal Procedures in Sweden 1998–2011: A Population-Based Study

Surgical care is constantly developing as demographic shifts occur and indications change when new techniques are introduced. The purpose of this study was to describe trends of in-hospital upper abdominal procedures in Sweden during 1998–2011.

Data were collected from the National Patient Register containing annual number of procedures and procedures per 100,000 inhabitants. Comparisons were made between the first 3 years (1998–2000) and last 3 years (2009–2011). High-volume procedures and resectional surgery were studied in particular.

During the study period, a total of 435,394 upper abdominal procedures were performed in 318,991 individuals. The number of procedures increased 44.9 % between the early and late period. Bariatric surgery increased almost sixfold, with a substantial increase in laparoscopic gastric bypass to 58.2/100,000/year. The most common operation was cholecystectomy, 144.9/100,000/year. Liver resections tripled and, in total, major resectional surgery, performed on the esophagus, stomach, liver, and pancreas, increased by 36.3 %. Per 100,000 adult inhabitants and year, resections of the esophagus was performed in 2.3 patients, stomach in 5.9, liver in 9.0, and pancreas in 5.7, in late time period. An increase in all types of endoscopic work was observed.

In total, the number of upper abdominal procedures performed per inhabitant increased. Laparoscopic gastric bypass increased substantially and became the second most common procedure after laparoscopic cholecystectomy. An increase in resectional surgery was observed.