Gallstone disease natural history, complications and prognosis
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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
Gallstones develop in many people without causing symptoms. The chance of symptoms or complications from gallstones is about 20%. Nearly all patients (99%) who have gallbladder surgery do not have their symptoms return.[1]
Natural History, Complications, and Prognosis
Natural History
- Gallstone disease is typically asymptomatic. 16-26% of patients develop gallstone-related symptoms in 10 years. Prophylactic cholecystectomy is not indicated unless symptoms develop or there is an increased risk of gallbladder cancer:[1]
- Pima Indian
- Calcified gallbladder
- Gallbladder polyp >10 mm
- Gallstones >2.5 cm
- Salmonella carrier
Complications
- Common complications of gallbladder disease include:
- Acute cholecystitis
- Choledocholithiasis with or without acute cholangitis
- Gallstone pancreatitis[2]
Diagrams shown below:
Source:medicalassessmentonline[3]
Symptomatic stones
The patients whom experience an episode of pain recurrence (biliary colic) once per year are around 38-50%.[4]
Prognosis
- The prognosis in patients with Gallstone disease is dependent upon the occurence and severity of complications. The category of patients whom refuse or are unfit for surgery will remain asymptomatic 45% of the time, whilst 55% will have varying degrees of complications.[5]
References
- ↑ 1.0 1.1 Gracie WA, Ransohoff DF (1982). "The natural history of silent gallstones: the innocent gallstone is not a myth". N. Engl. J. Med. 307 (13): 798–800. doi:10.1056/NEJM198209233071305. PMID 7110244.
- ↑ Friedman GD (1993). "Natural history of asymptomatic and symptomatic gallstones". Am. J. Surg. 165 (4): 399–404. PMID 8480871.
- ↑ "Gallbladder disease".
- ↑ Festi D, Reggiani ML, Attili AF, Loria P, Pazzi P, Scaioli E, Capodicasa S, Romano F, Roda E, Colecchia A (2010). "Natural history of gallstone disease: Expectant management or active treatment? Results from a population-based cohort study". J. Gastroenterol. Hepatol. 25 (4): 719–24. doi:10.1111/j.1440-1746.2009.06146.x. PMID 20492328.
- ↑ 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.