Long-term follow-up of patients with gallbladder in situ after endoscopic sphincterotomy for choledocholithiasis. 1991

E Kullman, and K Borch, and L G Dahlin, and G Liedberg
Department of Surgery, Central Hospital, Eskilstuna, Sweden.

Endoscopic sphincterotomy (EST) was performed on 148 patients with common bile duct stones and intact gallbladder. The duct was cleared in 130 cases (88%). Immediate complications occurred in 23 patients (15.5%), six of whom died. In 118 of the 139 patients discharged from the hospital, the bile ducts were cleared and the gallbladder in situ. The median observation time in these 118 cases was 42 (1-97) months, during which 13 (11%) were cholecystectomized because of symptoms or acute complications due to remaining gallbladder stones, and 49 (42%) died 2-87 (median 24) months after EST. The probability (life-table) of remaining free from cholecystectomy-requiring symptoms or complications was 0.87 after 42 months. There was no association between nonfilling of the gallbladder at ERC and subsequent problems with gallbladder stones. EST for choledocholithiasis with retained gallbladder is justified for elderly and frail patients. Indefinite postponement of cholecystectomy may be warrantable, restricting surgery to patients with symptoms from gallbladder stones. This most frequently means within 2 years after EST.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D002763 Cholecystectomy Surgical removal of the GALLBLADDER. Cholecystectomies
D002769 Cholelithiasis Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS). Gallstone Disease,Cholelithiases,Gallstone Diseases
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
D005704 Gallbladder A storage reservoir for BILE secretion. Gallbladder allows the delivery of bile acids at a high concentration and in a controlled manner, via the CYSTIC DUCT to the DUODENUM, for degradation of dietary lipid. Gallbladders
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute

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