Appropriateness of cholecystectomy in the United Kingdom--a consensus panel approach.

E A Scott, N Black

Department of Public Health and Policy, London School of Hygiene and Tropical Medicine.

A consensus development approach was used to assess the extent to which doctors in the UK agreed about the appropriate indications for cholecystectomy. Two panels, one composed entirely of surgeons and one containing a mix of relevant specialists, were asked to rate a series of possible indications. A consensus was achieved for 61% (surgical panel) and 67% (mixed panel) of indications considered. The surgical panel considered more indications as being appropriate for cholecystectomy (29% v 13%) and fewer indications as being inappropriate (27% v 50%) than the mixed panel. For between one third and a half of all indications, the panels were unable to reach agreement, partly as a result of differences in views as to the role of endoscopic sphincterotomy.

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