General

Should we treat asymptomatic Gallstones in Gallbladder ????

Created by:

 
24 Aug 2016 - General
 

The risk factors of developing gallstones are increased body mass index, central obesity, increasing age, and female. Having gallstones can be symptomatic. Gallstones can possible lead to acute cholycystitis, or biliary  colic / obstruction which can lead to ascending cholangitis. When gallstones escapes into common bile duct, it can lead to biliary colic with severe, episodic right upper quadrant pain, with jaundice. But, around 60% to 80% of population of having gallstones are symptomatic. The risk of developing symptoms are around 2% to 4%. Patient with symptomatic gallstones should be offered cholecystectomy.  However, the asymptomatic cohort of having gallstones, there is no advantages of having a prophylactic cholecystectomy, as the risk of developong symptoms are low. Would you agree with this ??  

Mark Edmon Tan: Yes watchful waiting. It is again hard at times to tell a patient "let us observe this" as it makes us sound like we are waiting for complications to occur or for the worst. Once again it requires proper explanation to avoid such negative connotations. Marinelle Castro: Those are definitely very good fact...
 (Total 137 words)
Jennifer Winter I absolutely agree. Surgeries, regardless of how "minor" they are, still have a certain percentage of complications that one should consider. Explaining the need to change their diet to a low-fat diet, as this stimulates CCK release that causes pain via gallbladder contraction, is a huge factor in successfully managing asymptomatic gallstones. Surgeons have also coined the term "wat...
 (Total 116 words)
I'm not a Gastroenterologist, but I remember reading about asymptomatic cholelithiasis in our GI block saying "a recommendation for cholecystectomy in a patient with gallstones should probably be based on assessment of three factors: (1) the presence of symptoms that are frequent enough or severe enough to interfere with the patient’s general routine; (2) the presence of a prior complication of gallstone disease, i.e., history of acute cholecystitis, pancreatitis, gallstone fis...
 (Total 130 words)
International recommendations state that there is no benefit to the treatment of asymptomatic gallstone disease. The risk of surgery, such as acute complicaations and pancreatitis has an approximate morbidity rate of 2.5-10% according to the World Gastroenterology association. However, there are a few exceptions to this rule. These are 1)Patients who live in a remote area with poor access to medical care. 2) Patients who are on immunosuppressants who have a greater risk of developing catastrophi...
 (Total 128 words)