Gallstone disease natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
Gallstone disease patients should not undergo an elective [[cholecystectomy]] until symptoms develop, since almost 55% of patients will remain [[asymptomatic]]. Also, the [[Complication (medicine)|complications]] of [[asymptomatic]] gallstones are almost negligible unless symptoms develop. The complications of gallstone disease include [[acute cholecystitis]], [[Jaundice|obstructive jaundice]], | Gallstone disease patients should not undergo an elective [[cholecystectomy]] until symptoms develop, since almost 55% of patients will remain [[asymptomatic]]. Also, the [[Complication (medicine)|complications]] of [[asymptomatic]] gallstones are almost negligible unless symptoms develop. The complications of gallstone disease include [[acute cholecystitis]], [[Jaundice|obstructive jaundice]], [[acute cholangitis]] and [[acute pancreatitis]]. The prognosis after [[Cholecystectomy|laparoscopic cholecystectomy]] is excellent with [[morbidity]] and [[Mortality rate|mortality]] rates being as low as 0.5 and 10% respectively. | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
*Gallstone disease usually develops in the third decade of life, and can start asymptomatically.<ref name="pmid4015212">{{cite journal |vauthors=McSherry CK, Ferstenberg H, Calhoun WF, Lahman E, Virshup M |title=The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients |journal=Ann. Surg. |volume=202 |issue=1 |pages=59–63 |year=1985 |pmid=4015212 |pmc=1250837 |doi= |url=}}</ref> | *Gallstone disease usually develops in the third decade of life, and can start asymptomatically.<ref name="pmid4015212">{{cite journal |vauthors=McSherry CK, Ferstenberg H, Calhoun WF, Lahman E, Virshup M |title=The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients |journal=Ann. Surg. |volume=202 |issue=1 |pages=59–63 |year=1985 |pmid=4015212 |pmc=1250837 |doi= |url=}}</ref> | ||
*Symptoms of biliary colic may develop such as [[abdominal pain]], [[fever]] and, [[jaundice]]. | *Symptoms of [[biliary colic]] may develop such as [[abdominal pain]], [[fever]] and, [[jaundice]]. | ||
*If left untreated, only 10% of patients with gallstone disease may progress to develop symptoms. | *If left untreated, only 10% of patients with gallstone disease may progress to develop symptoms. | ||
===Complications=== | ===Complications=== | ||
*Common complications of gallstone disease include:<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> | *Common complications of gallstone disease include:<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> | ||
** | **[[Acute cholecystitis]] | ||
**Gallbladder [[perforation]] | **[[Gallbladder]] [[perforation]] | ||
**[[Jaundice|Obstructive jaundice]] | **[[Jaundice|Obstructive jaundice]] | ||
**[[Choledocholithiasis]] with or without | **[[Choledocholithiasis]] with or without [[acute cholangitis]] | ||
**Gallbladder [[fistula]] | **[[Gallbladder]] [[fistula]] | ||
**[[Cholangiocarcinoma]] | **[[Cholangiocarcinoma]] | ||
**[[Pancreatitis|Gallstone pancreatitis]] | **[[Pancreatitis|Gallstone pancreatitis]] | ||
| Line 30: | Line 28: | ||
*Elective [[cholecystectomy]] has a [[Mortality rate|mortality]] rate and [[morbidity]] rate of 0.5% and 10% respectively.<ref name="pmid26895902">{{cite journal |vauthors=Julliard O, Hauters P, Possoz J, Malvaux P, Landenne J, Gherardi D |title=Incisional hernia after single-incision laparoscopic cholecystectomy: incidence and predictive factors |journal=Surg Endosc |volume=30 |issue=10 |pages=4539–43 |year=2016 |pmid=26895902 |doi=10.1007/s00464-016-4790-4 |url=}}</ref> | *Elective [[cholecystectomy]] has a [[Mortality rate|mortality]] rate and [[morbidity]] rate of 0.5% and 10% respectively.<ref name="pmid26895902">{{cite journal |vauthors=Julliard O, Hauters P, Possoz J, Malvaux P, Landenne J, Gherardi D |title=Incisional hernia after single-incision laparoscopic cholecystectomy: incidence and predictive factors |journal=Surg Endosc |volume=30 |issue=10 |pages=4539–43 |year=2016 |pmid=26895902 |doi=10.1007/s00464-016-4790-4 |url=}}</ref> | ||
*Emergent [[cholecystectomy]] has a [[Mortality rate|mortality]] rate and [[morbidity]] rate of 3-5% and 30-50% respectively. | *Emergent [[cholecystectomy]] has a [[Mortality rate|mortality]] rate and [[morbidity]] rate of 3-5% and 30-50% respectively. | ||
*The risk of developing an [[incisional hernia]] after a | *The risk of developing an [[incisional hernia]] after a [[laparoscopic cholecystectomy]] is about 8% in patients over 50 years of age. | ||
*Patients with gallstones in the gallbladder have an associated [[choledocholithiasis]] (stone in the common bile duct) in 10-15% of the time. | *Patients with gallstones in the [[gallbladder]] have an associated [[choledocholithiasis]] (stone in the [[common bile duct]]) in 10-15% of the time. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Hepatology]] | [[Category:Hepatology]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
Latest revision as of 21:48, 29 July 2020
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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
Gallstone disease patients should not undergo an elective cholecystectomy until symptoms develop, since almost 55% of patients will remain asymptomatic. Also, the complications of asymptomatic gallstones are almost negligible unless symptoms develop. The complications of gallstone disease include acute cholecystitis, obstructive jaundice, acute cholangitis and acute pancreatitis. The prognosis after laparoscopic cholecystectomy is excellent with morbidity and mortality rates being as low as 0.5 and 10% respectively.
Natural History, Complications, and Prognosis
Natural History
- Gallstone disease usually develops in the third decade of life, and can start asymptomatically.[1]
- Symptoms of biliary colic may develop such as abdominal pain, fever and, jaundice.
- If left untreated, only 10% of patients with gallstone disease may progress to develop symptoms.
Complications
- Common complications of gallstone disease include:[2]
Prognosis
- Elective cholecystectomy has a mortality rate and morbidity rate of 0.5% and 10% respectively.[3]
- Emergent cholecystectomy has a mortality rate and morbidity rate of 3-5% and 30-50% respectively.
- The risk of developing an incisional hernia after a laparoscopic cholecystectomy is about 8% in patients over 50 years of age.
- Patients with gallstones in the gallbladder have an associated choledocholithiasis (stone in the common bile duct) in 10-15% of the time.
References
- ↑ McSherry CK, Ferstenberg H, Calhoun WF, Lahman E, Virshup M (1985). "The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients". Ann. Surg. 202 (1): 59–63. PMC 1250837. PMID 4015212.
- ↑ Friedman GD (1993). "Natural history of asymptomatic and symptomatic gallstones". Am. J. Surg. 165 (4): 399–404. PMID 8480871.
- ↑ 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.