NATIONAL TRENDS IN CHOLECYSTECTOMY IN MEXICO FROM 2008-2023: A NATIONWIDE RETROSPECTIVE ANALYSIS dario.rocha@udem.edu

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NATIONAL TRENDS IN CHOLECYSTECTOMY IN MEXICO FROM 2008-2023: A NATIONWIDE RETROSPECTIVE ANALYSIS

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Tarsicio Uribe-Leitz tarsiciouribe@gmail.com Harvard Medical School Program in Global Surgery and Social Change Boston, MA United States Boston Children’s Hospital Department Of Plastic Surgery And Oral Surgery Boston, MA United States

United States

Oral or Poster

Cholecystectomy is among the most frequently performed planned essential surgeries (PES) worldwide, yet access to PES remains limited in low- and middle-income countries. This study examines national trends in PES provision, using cholecystectomy as a proxy, within Mexico’s public healthcare system.

We conducted a retrospective cross-sectional analysis of all cholecystectomies performed in public hospitals from 2008–2023, using the Ministry of Health’s national hospital discharge and procedure registries. Cases were identified by ICD-9-PCS codes 51.23, 51.24, 51.22, and 51.21; Surgical volumes were analyzed by year, state, and sociodemographic characteristics. Trends were assessed using Chi-square tests, Poisson or negative binomial regression, and multivariable logistic regression to estimate adjusted odds of laparoscopic surgery by demographic and health coverage variables.

A total of 902,976 cholecystectomies were performed: 64.3% open and 35.7% laparoscopic. Both approaches declined sharply in 2020 during the COVID-19 pandemic but exceeded pre-pandemic levels by 2023. Open surgery significantly decreased over time (β = –9,145; p = 0.04), while laparoscopic volumes showed a non-significant increase. Geographic disparities were marked, with southeastern states showing the lowest laparoscopic adoption. Patients in more recent years had higher odds of undergoing laparoscopic surgery; those insured through Seguro Popular had lower odds compared with other coverage types. Clinical outcomes were generally similar, although in-hospital mortality was higher for open surgery (9.0 vs 6.0 per 1,000 discharges).

While access to laparoscopic cholecystectomy in Mexico has expanded, open surgery remains predominant. Geographic and socioeconomic disparities underscore the need for policies that enhance equitable access to minimally invasive surgery nationwide.