A Study of Symptomatic and “Silent” Gallstone

Abdominal symptoms: do they disappear after cholecystectomy?

“…Inclusion and exclusion criteria were poorly or not described in 10 studies [3,6,10,11,14,21,38,41,42]; sex and age distribution were not described in 3 studies [34,42,47]. One study did not describe the intervention performed (open or laparoscopic cholecystectomy) [1].…”

“…The methods used for evaluation of the presence of abdominal symptoms were poorly described or lacked validity in 12 studies [1,6,10,11,13,15,21,31,32,34,38,42]. One study did not report the duration of followup [42].…”

“…One study did not report the duration of followup [42]. Mean follow-up was £ 12 months in 10 studies [1,3,6,10,11,20,23,29,31,34,41,46]. Loss to followup was not reported or more than 20% in 5 studies [11,32,34,38,46].…”

“…Eight publications (35%) lacked three or more quality criteria [1,6,10,11,31,34,42,46]. Four of these studies had been published before 1990 ( Table 1).…”

Natural History of Biliary Stones

“…Bouchier et al [28] compared the number, size, and contents of mucus sub stances in gallstones from 17 patiens with symptomatic and 24 with asymptomatic cholelithiasis and found them to be similar; none of the patients produced organ-specific antibodies to gallbladder tissue. In an Italian epidemiology study (GREPCO) [29], x-ray characteristics of gallstones did not differ between men (n = 47) and women (n = 31), and the presence of biliary symptoms in the 5 years prior to this cross-sectional study was not related to any radiologic feature, includ ing whether or not the gallbladder was vi sualized on oral cholecystography.…”