Some Clinical Observations on Patients With Gallstones

Gunn, Alexander D. G.; Keddie, Nigel

doi:10.1016/s0140-6736(72)91683-2

Cited by 60 publications

(24 citation statements)

References 7 publications

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“…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].…”

Section: Quality Assessmentmentioning

confidence: 99%

Abdominal symptoms: do they disappear after cholecystectomy?

2003

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Section: Quality Assessmentmentioning

confidence: 99%

Abdominal symptoms: do they disappear after cholecystectomy?

2003

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“…However, it is the postoperative ileus, discomfort, and disability that most patients find objectionable and it is these attributes that have prompted evaluation of less-invasive alternatives. A significant percentage of patients undergoing surgical cholecystectomy complain postoperatively of symptoms similar to those that prompted surgical treatment (Table 2) [7,8,24,36,60,68]. Explanations of this "postcholecystectomy syndrome" are quite varied.…”

Section: Resultsmentioning

confidence: 99%

“…Cholecystectomy is associated with a recognized morbidity and mortality (Table 1) [3, 14, 17, 28, 35, 42, 44, 45, 50-52, 59, 72]. Moreover, a significant percentage of patients continue to have abdominal symptoms months to years following cholecystectomy (Table 2) [7,8,24,36,60,68]. Furthermore, there are reports suggesting that cholecystectomy may increase the risk of colon cancer (Table 3) [1,2,6,10,20,34,40,41,47,49,56,57,66,[74][75][76][77][78].…”

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confidence: 99%

Percutaneous endoscopic treatment of cholelithiasis

Griffith

Rubio²,

Gleeson

1990

Surg Endosc

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Surgical management of gallstones was first performed successfully in 1878. Over the past decade, several new treatment alternatives have evolved that challenge the supremacy of traditional surgical cholecystectomy. Two endoscopic alternatives, e.g., percutaneous cholecystolithotomy (PCCL) and laparoscopic cholecystectomy (LC) are the latest additions to the growing armamentarium. Our initial experience with PCCL and LC as compared with our traditional cholecystectomy experience shows a 57% reduction in hospital days, a 58% reduction in postoperative analgesic dose, and 50% or more reduction in disabling convalescence in favor of the endoscopic alternatives. A review of the efficacy and morbidity of traditional surgery, peroral drug chemolysis (PDC), shockwave lithotripsy plus PDC, and percutaneous transhepatic lavage with methyl terbutyl ether suggests that the endoscopic alternatives are less morbid than traditional surgery and more efficacious and perhaps less morbid than other non-invasive or minimally invasive alternatives. Both original data and a literature review are presented.

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“…Several older studies note the presence of normal liver tests in a small percentage of patients but did not characterize these patients further [6,7,8]. To our knowledge, there has been only one prior study specifically addressing normal liver chemistry tests in patients with choledocholithiasis [15].…”

Section: Discussionmentioning

confidence: 99%

“…Choledocholithiasis is concurrently present in approximately 5-10% of patients with gallbladder stones [3,4,5]. Many studies have examined factors associated with the presence of coexistent common bile duct (CBD) stones in patients with gallbladder stones including biliary dilatation on imaging, as well as pattern and elevation of abnormal liver tests [6,7,8,9,10,11,12,13,14]. Indeed, abnormal liver chemistry tests are considered the hallmark of CBD stones.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Normal Liver Tests in Patients with Choledocholithiasis Undergoing Endoscopic Retrograde Cholangiopancreatography

Wilcox

Kim

Trevino³

et al. 2014

Digestion

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Background/Aims: Abnormal liver chemistry tests are a hallmark of common bile duct (CBD) stones. There is little information, however, on the prevalence of and predictors for normal liver chemistry tests in such patients. Methods: Over an 11-year period, all patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) at our Center were prospectively identified. Patients in this study were those with CBD stones found at ERCP and where the indication for ERCP was CBD stones seen on imaging studies or when CBD stones were highly suspected based upon clinical presentation and radiographic and laboratory findings. Liver chemistry tests were recorded from those taken at the time of initial presentation as well as the time closest to ERCP. Results: Of a total of 5,133 patients undergoing ERCP during the study period, the indication was suspicion for CBD stones or for radiographically identified CBD stones in 476 and 593, respectively, with 115 patients having both indications. Of these 1,184 patients, 765 had CBD stones of whom 541 had liver tests. Of these 541, 29 patients (5.4%) were found to consistently have normal liver chemistry tests. Multivariate analysis identified two factors predictive of normal liver tests including age >55 years and the presence of abdominal pain. Conclusions: Although rare, liver tests can be normal in patients with CBD stones. Patients most likely to have normal liver tests included older patients and those with abdominal pain.

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Some Clinical Observations on Patients With Gallstones

Cited by 60 publications

References 7 publications

Abdominal symptoms: do they disappear after cholecystectomy?

Abdominal symptoms: do they disappear after cholecystectomy?

Percutaneous endoscopic treatment of cholelithiasis

Prevalence of Normal Liver Tests in Patients with Choledocholithiasis Undergoing Endoscopic Retrograde Cholangiopancreatography

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