Acalculous gallbladder disease: the outcomes of treatment by laparoscopic cholecystectomy

Ahmed, M; Diggory, R

doi:10.1308/003588411x563402

Cited by 12 publications

(8 citation statements)

References 11 publications

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“…However, ultrasound is highly accurate for steatosis and is widely used clinically and in population-based studies [ 71 ]. Second, the information on the indications for cholecystectomy was not available; thus, we could not differentiate cholecystectomy unrelated to gallstones [ 35 , 36 ]. However, the majority of gallstones are not associated with symptoms [ 72 ]; thus, incidental asymptomatic gallstones as a separate outcome in our study could lead to a better understanding of the development of gallstones.…”

Section: Discussionmentioning

confidence: 99%

“…A cholecystectomy can be performed due to acalculous gallbladder diseases such as gallbladder polyps, tumors, acalculous cholecystitis, and biliary dyskinesia, which collectively represent between 5% and 30% of laparoscopic cholecystectomies [ 35 , 36 ]. Because the indications for the cholecystectomies were not available, we used ultrasound-documented gallstones as the primary endpoint.…”

Section: Methodsmentioning

confidence: 99%

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Bidirectional Association between Nonalcoholic Fatty Liver Disease and Gallstone Disease: A Cohort Study

Chang

Noh

Suh

et al. 2018

JCM

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Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GD) are often found to coexist but the sequential relationship of NAFLD and GD to each other remains controversial. We prospectively evaluated the bidirectional relationship of NAFLD with GD. A cohort study was performed on Korean adults who underwent a health checkup and were followed annually or biennially for a mean of 6.0 years. Fatty liver and gallstones were diagnosed by ultrasound. NAFLD was defined as hepatic steatosis on ultrasonography in the absence of excessive alcohol use or other identifiable causes. The NAFLD severity was determined by non-invasive fibrosis markers. Among 283,446 participants without either gallstones or cholecystectomy at baseline, 6440 participants developed gallstones. Among 219,641 participants without NAFLD at baseline, 49,301 participants developed NAFLD. The multivariable-adjusted hazard ratio (95% confidence interval) for incident gallstone comparing the NAFLD group vs. the non-NAFLD group was 1.26 (1.17–1.35). Increased non-invasive fibrosis markers of NAFLD were positively associated with an increased incidence of gallstones in a graded and dose-responsive manner (p-trend < 0.01). The multivariable-adjusted hazard ratios (95% confidence intervals) for incident NAFLD comparing gallstone and cholecystectomy to no GD were 1.14 (1.07–1.22) and 1.17 (1.03–1.33), respectively. This large-scale cohort study of young and middle-aged individuals demonstrated a bidirectional association between NAFLD and GD. NAFLD and its severity were independently associated with an increased incidence of gallstones, while GD and cholecystectomy were also associated with incident NAFLD. Our findings indicate that the conditions may affect each other, requiring further studies to elucidate the potential mechanisms underlying this association.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Bidirectional Association between Nonalcoholic Fatty Liver Disease and Gallstone Disease: A Cohort Study

Chang

Noh

Suh

et al. 2018

JCM

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“…Her abdominal pain was worsening, she did not tolerate pain medications and she had high EBV viral load which usually correlates with disease severity [ 11 ]. Conservative management was advised initially but she opted for surgery and had laparoscopic cholecystectomy [ 12 , 13 ]. She received a single dose of intravenous Cefazolin preoperatively.…”

Section: Discussionmentioning

confidence: 99%

Acute Acalculous Cholecystitis due to primary acute Epstein-Barr virus infection treated with laparoscopic cholecystectomy; a case report

Rezkallah

Barakat

Farrah

et al. 2018

Annals of Medicine and Surgery

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IntroductionEpstein Barr virus (EBV) is a human herpes virus 4, transmitted through intimate contact between susceptible persons and asymptomatic EBV shedders. It usually presents with fever, pharyngitis and lymphadenopathy. Majority of individuals with primary EBV infection recover uneventfully. Acute Acalculous Cholecystitis (AAC) is usually seen in hospitalized and critically ill patients with major trauma, shock, severe sepsis, total parenteral nutrition and mechanical ventilation.Case presentationWe report a 25-year- old woman presented with acute Epstein-Barr Virus (EBV)infection and hepatobiliary iminodiacetic acid (HIDA) scan confirmed presence of Acute Acalculous Cholecystitis (AAC). Conservative management was advised initially, but she had a laparoscopic cholecystectomy due to intolerable abdominal pain.ConclusionAAC is a rare complication of acute EBV infection and it is usually managed conservatively, although our patient had laparoscopic cholecystectomy due to intolerable abdominal pain.

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“…The authors concluded that surgery was effective in controlling symptoms and allowing patients to return to normal lifestyle. 19 Jones-Monahan et al demonstrated that among 45 symptomatic patients with GBPs and no stones who underwent cholecystectomy, 93% reported relief of symptoms. 20 , 21 The remaining two patients experienced dyspepsia that did not interfere with daily activity.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up

Qandeel¹,

Nassar²,

Ng³

et al. 2021

JSLS

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Aim: This study aims to evaluate the incidence, indications, management, and long term follow up of cholecystectomy in patients with no gallstones, other than acalculous acute cholecystitis. Methods: Prospectively collected data of 5675 patients undergoing laparoscopic cholecystectomy (LC) over 28 years was extracted and analyzed. Patients with biliary symptoms, no stones on ultrasound scans and abnormal hepatobiliary iminodiacetic acid scans, and those with confirmed gallbladder polyps (GBP) were included. Results: Two percent of cholecystectomies were performed in patients with acalculous pathology [1.3% functional gallbladder disorder (FGBD) and 0.7% GBP]. The 114 patients were younger, had lower American Society of Anesthesiologists classification, and had fewer previous biliary admissions than those with gallstones (5560). The clinical presentations of FGBD were chronic biliary symptoms (93.1%) and acute biliary pain (6.9%). GBP patients presented with chronic biliary symptoms. LC in 98.6% FGBD and 92.8% GBP were significantly easier than those for gall stones (P < 0.0001). They were significantly (P < 0.0001 FGBD and P < 0.001 GBP) less likely to have adhesions to the gallbladder. This ease was reflected in shorter operation times and lower utilization of abdominal drains. Polyp numbers ranged from 1 to 30 and sizes from 1 mm to 11 mm. No malignant polyps were encountered. In 95.8% FGBD and 95% GBP, patients had a good symptomatic response to LC. Conclusions: FGBD and GBP are uncommon in patients undergoing LC. FGBD should be considered during evaluation of right upper quadrant pain with no gall stones. Laparoscopic cholecystectomy may be considered as it achieves long term symptomatic relief in most patients with FGBD and GBP.

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Acalculous gallbladder disease: the outcomes of treatment by laparoscopic cholecystectomy

Abstract: We therefore conclude that laparoscopic surgery for patients with acalculous gallbladder disease is effective in symptom control and allowing patients to return to their normal lifestyle.

Cited by 12 publications

References 11 publications

Bidirectional Association between Nonalcoholic Fatty Liver Disease and Gallstone Disease: A Cohort Study

Bidirectional Association between Nonalcoholic Fatty Liver Disease and Gallstone Disease: A Cohort Study

Acute Acalculous Cholecystitis due to primary acute Epstein-Barr virus infection treated with laparoscopic cholecystectomy; a case report

Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up

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