Gallstone disease natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
Gallstones develop in many people without causing symptoms. The chance of symptoms or complications from gallstones is about 20%. Nearly all patients (99%) who have gallbladder surgery do not have their symptoms return.<ref name="pmid7110244">{{cite journal |vauthors=Gracie WA, Ransohoff DF |title=The natural history of silent gallstones: the innocent gallstone is not a myth |journal=N. Engl. J. Med. |volume=307 |issue=13 |pages=798–800 |year=1982 |pmid=7110244 |doi=10.1056/NEJM198209233071305 |url=}}</ref> | Gallstones develop in many people without causing [[Symptom|symptoms]]. The chance of symptoms or [[Complication (medicine)|complications]] from gallstones is about 20%. Nearly all patients (99%) who have [[Cholecystectomy|gallbladder surgery]] do not have their symptoms return.<ref name="pmid7110244">{{cite journal |vauthors=Gracie WA, Ransohoff DF |title=The natural history of silent gallstones: the innocent gallstone is not a myth |journal=N. Engl. J. Med. |volume=307 |issue=13 |pages=798–800 |year=1982 |pmid=7110244 |doi=10.1056/NEJM198209233071305 |url=}}</ref> | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
*Gallstone disease is typically asymptomatic. 16-26% of patients develop gallstone-related symptoms in 10 years. Prophylactic cholecystectomy is not indicated unless symptoms develop or there is an increased risk of gallbladder cancer:<ref name="pmid7110244">{{cite journal |vauthors=Gracie WA, Ransohoff DF |title=The natural history of silent gallstones: the innocent gallstone is not a myth |journal=N. Engl. J. Med. |volume=307 |issue=13 |pages=798–800 |year=1982 |pmid=7110244 |doi=10.1056/NEJM198209233071305 |url=}}</ref> | *Gallstone disease is typically asymptomatic. 16-26% of patients develop gallstone-related symptoms in 10 years. [[Prophylaxis|Prophylactic]] [[cholecystectomy]] is not indicated unless symptoms develop or there is an increased risk of [[gallbladder cancer]]:<ref name="pmid7110244">{{cite journal |vauthors=Gracie WA, Ransohoff DF |title=The natural history of silent gallstones: the innocent gallstone is not a myth |journal=N. Engl. J. Med. |volume=307 |issue=13 |pages=798–800 |year=1982 |pmid=7110244 |doi=10.1056/NEJM198209233071305 |url=}}</ref> | ||
:*Pima Indian | :*Pima Indian | ||
:*Calcified gallbladder | :*[[Calcification|Calcified]] gallbladder | ||
:*Gallbladder polyp >10 mm | :*Gallbladder [[polyp]] >10 mm | ||
:*Gallstones >2.5 cm | :*Gallstones >2.5 cm | ||
:*Salmonella carrier | :*[[Salmonella]] [[carrier]] | ||
===Complications=== | ===Complications=== | ||
*Common complications of Gallbladder disease include: | *Common complications of Gallbladder disease include: | ||
**Acute cholecystitis | **Acute [[cholecystitis]] | ||
**Choledocholithiasis with or without acute cholangitis | **[[Choledocholithiasis]] with or without acute [[cholangitis]] | ||
**Gallstone | **[[Pancreatitis|Gallstone pancreatitis]]<ref name="pmid8480871">{{cite journal |vauthors=Friedman GD |title=Natural history of asymptomatic and symptomatic gallstones |journal=Am. J. Surg. |volume=165 |issue=4 |pages=399–404 |year=1993 |pmid=8480871 |doi= |url=}}</ref> | ||
Diagrams shown below are courtesy of [http://www.wikisurgery.com Wikisurgery.com] | Diagrams shown below are courtesy of [http://www.wikisurgery.com Wikisurgery.com] | ||
Revision as of 18:18, 27 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
Gallstones develop in many people without causing symptoms. The chance of symptoms or complications from gallstones is about 20%. Nearly all patients (99%) who have gallbladder surgery do not have their symptoms return.[1]
Natural History, Complications, and Prognosis
Natural History
- Gallstone disease is typically asymptomatic. 16-26% of patients develop gallstone-related symptoms in 10 years. Prophylactic cholecystectomy is not indicated unless symptoms develop or there is an increased risk of gallbladder cancer:[1]
- Pima Indian
- Calcified gallbladder
- Gallbladder polyp >10 mm
- Gallstones >2.5 cm
- Salmonella carrier
Complications
- Common complications of Gallbladder disease include:
- Acute cholecystitis
- Choledocholithiasis with or without acute cholangitis
- Gallstone pancreatitis[2]
Diagrams shown below are courtesy of Wikisurgery.com
Symptomatic stones
38-50% of patients have pain recurrence every year after 1 episode biliary colic.[3]
Prognosis
- The prognosis in patients with Gallstone disease is dependent upon the occurence and severity of complications. The category of patients whom refuse or are unfit for surgery will remain asymptomatic 45% of the time, whilst 55% will have varying degrees of complications.[4]
References
- ↑ 1.0 1.1 Gracie WA, Ransohoff DF (1982). "The natural history of silent gallstones: the innocent gallstone is not a myth". N. Engl. J. Med. 307 (13): 798–800. doi:10.1056/NEJM198209233071305. PMID 7110244.
- ↑ Friedman GD (1993). "Natural history of asymptomatic and symptomatic gallstones". Am. J. Surg. 165 (4): 399–404. PMID 8480871.
- ↑ Festi D, Reggiani ML, Attili AF, Loria P, Pazzi P, Scaioli E, Capodicasa S, Romano F, Roda E, Colecchia A (2010). "Natural history of gallstone disease: Expectant management or active treatment? Results from a population-based cohort study". J. Gastroenterol. Hepatol. 25 (4): 719–24. doi:10.1111/j.1440-1746.2009.06146.x. PMID 20492328.
- ↑ Julliard O, Hauters P, Possoz J, Malvaux P, Landenne J, Gherardi D (2016). "Incisional hernia after single-incision laparoscopic cholecystectomy: incidence and predictive factors". Surg Endosc. 30 (10): 4539–43. doi:10.1007/s00464-016-4790-4. PMID 26895902.