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Hvad sker der hos personer med galdeblaeresten, hvis de ikke får foretaget kolecystektomi? Opfölgning af 222 konsekutive patienter med initialt ubehandlet galdestenssygdom
Engelsk titel: What happens to gallstone patients discharged without cholecystectomy? Follow-up of 222 consecutive patients with initially untreated gallstones Läs online Författare: Boel T ; Schulze S ; Kristiansen VB ; Ravn Eriksen J Språk: Dan Antal referenser: 5 Dokumenttyp: Artikel UI-nummer: 07101608

Tidskrift

Ugeskrift for Laeger 2007;169(43)3649-52 ISSN 0041-5782 E-ISSN 1603-6824 KIBs bestånd av denna tidskrift Denna tidskrift är expertgranskad (Peer-Reviewed)

Sammanfattning

Introduction: The aim of this study was to investigate the cholecystectomy rate and rate of gallstone-related complications in patients formerly seen and discharged without operation from the Clinic for Day-Surgery, Glostrup University Hospital, Denmark. Materials and methods: From January 2000 to December 2002 a total of 222 patients with gallstones were discharged without operation (lap. cholecystectomy) from the day-surgery clinic. All admittances and surgical procedures in the follow-up period were identified by reading patient files and strategic searches in the National Patient Register in which all operations in Denmark are registered. Results: The median follow-up period was 37 months (range 5-62 months). 25% of patients were operated in the follow-up period (cholecystectomy, n = 54, gallstone ileus, n=1). 13% had gallstone-related complications in the follow-up period. 9 patients had one or more endoscopic retrograde cholangiographies. There was no mortality or serious surgical complications. Conclusion: There is a lack of objective criteria for cholecystectomy in symptomatic cholecystolithiasis. The national guidelines in Denmark advocate cholecystectomy only in patients with socially disabling pain attacks. These guidelines are followed in our department and the strategy seems acceptable and patient-friendly, although the optimal treatment strategy for patients with symptomatic gallstone disease is still unknown.