Chronic acalculous gallbladder disease: outcomes of treatment by laparoscopic cholecystectomy. 2004

Sorinel Luncă, and George Bouras, and Narcis Sandy Romedea
Emergency Surgical Clinic, University of Medicine and Pharmacy "Gr. T. Popa" Iaşi, Romania. slunca@hotmail.com.

OBJECTIVE The diagnosis and treatment of chronic acalculous gallbladder disease (CAGD) remains controversial. Laparoscopic cholecystectomy (LC) is increasingly accepted as the treatment of choice for this condition. The purpose of this study was to analyse the outcomes from LC for CAGD and to identify potential prognostic factors. METHODS We retrospectively analysed 54 patients with a clinical diagnosis of CAGD. All patients underwent LC. The outcomes were evaluated at 12 months. Outcomes from surgery were graded on a predetermined scoring system (score 1-6) reflecting the effect of surgery on symptomatology. Histopathological analysis was systematically performed on the resection specimens. RESULTS Post-operatively, 90.8% of patients (49/54) were satisfied with the operation (outcome score 1-2). A pathological abnormality was detected in 40 patients (74.1%). Of those in whom no abnormality detected on histopathological examination, LC achieved a successful outcome (score 1-2) in 85.7% of patients (12/14). The worst outcomes (score 5-6) were observed in 2 patients with a pathological abnormality of the gallbladder. For the 5 patients with outcome scores of 3 to 6 (poor outcome), the mean duration of symptoms was 7.1 months compared to 18.2 months for patients with score of 1 and 2 (good outcome). CONCLUSIONS There is no significant correlation between outcomes from LC for CAGD and the existence of a definable underlying pathology (p>0.05). Patients with long-standing symptoms were more likely to benefit from LC (p=0.039). LC is an appropriate treatment option for CAGD.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D005705 Gallbladder Diseases Diseases of the GALLBLADDER. They generally involve the impairment of BILE flow, GALLSTONES in the BILIARY TRACT, infections, neoplasms, or other diseases. Gall Bladder Diseases,Bladder Disease, Gall,Bladder Diseases, Gall,Disease, Gall Bladder,Disease, Gallbladder,Diseases, Gall Bladder,Diseases, Gallbladder,Gall Bladder Disease,Gallbladder Disease
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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