Speciality OPCS HRG Procedure Commissioning Position Evidence Base Monitoring code Oozing Change in sensation The CCG will support the funding of Updated General Cholecystectomy only Sanders G, Kingsnorth AN. Surgery January cholecystectomy in incidental gallstones if Gallstones. BMJ. 2007;335:295-9. 2017 one or more of the following criteria are Sakorafas GH, Milingos D, Peros G. Adults only met: Asymptomatic cholelithiasis: is High risk of gall bladder cancer, cholecystectomy really needed? A e.g. gall bladder polyps critical reappraisal 15 years after the ≥1cm, porcelain gall bladder, strong family introduction of laparoscopic history cholecystectomy. Dig Dis Sci. (parent, child or sibling with 2007;52:1313-25. gallbladder cancer). Transplant recipient (pre or post transplant). Diagnosis of chronic haemolytic syndrome by a secondary care specialist. Increased risk of complications from gallstones, e.g. presence of stones in the common bile duct, stones Updated Interventional Interventional smaller treatment for Haemorrhoids 1.Davies RJ. Haemorrhoids. BMJ General Surgery January treatment for will be considered only if one of the Clinical Evidence. April 2006. 2017 Haemorrhoids following criteria are met: Available at: Adults only b/conditions/dsd/0415/0415.jsp 2.Brisinda G. How to treat Symptomatic 3rd and 4th degree haemorrhoids. BMJ 2000; 321: 582-3 haemorrhoids Recurrent 2nd degree haemorrhoids with failed conservative treatment Persistent pain or bleeding *Conservative measures = high fibre diet, exercise, weight loss and topical preparations, followed by non-surgical ablative/fixative interventions and rubber band ligation. Documentation of dates and
Speciality OPCS code HRG Procedure Commissioning Position Evidence Base Monitoring Oozing Change in sensation Updated January 2017 General Surgery Adults only Cholecystectomy The CCG will only support the funding of cholecystectomy in incidental gallstones if one or more of the following criteria are met: High risk of gall bladder cancer, e.g. gall bladder polyps ≥1cm, porcelain gall bladder, strong family history (parent, child or sibling with gallbladder cancer). Transplant recipient (pre or post transplant). Diagnosis of chronic haemolytic syndrome by a secondary care specialist. Increased risk of complications from gallstones, e.g. presence of stones in the common bile duct, stones smaller Sanders G, Kingsnorth AN. Gallstones. BMJ. 2007;335:295-9. Sakorafas GH, Milingos D, Peros G. Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci. 2007;52:1313-25. Updated January 2017 General Surgery Adults only Interventional treatment for Haemorrhoids Interventional treatment for Haemorrhoids will be considered only if one of the following criteria are met: Symptomatic 3rd and 4th degree haemorrhoids Recurrent 2nd degree haemorrhoids with failed conservative treatment Persistent pain or bleeding *Conservative measures = high fibre diet, exercise, weight loss and topical preparations, followed by non-surgical ablative/fixative interventions and rubber band ligation. Documentation of dates and 1.Davies RJ. Haemorrhoids. BMJ Clinical Evidence. April 2006. Available at: b/conditions/dsd/0415/0415.jsp 2.Brisinda G. How to treat haemorrhoids. BMJ 2000; 321: 582-3
DCCG-Comm-for-Value_Decision-Making_Prioritisation-FINAL-April2017.docx