Current management of the gallbladder after endoscopic sphincterotomy for common bile duct stones

Gastrointestinal Endoscopy
Yolande C A KeulemansD J Gouma

Abstract

Traditionally, a cholecystectomy is performed after successful endoscopic sphincterotomy and removal of common bile duct (CBD) stones, except in patients of advanced age or with substantial comorbidity. In practice, however, the gallbladder is left in situ more frequently now in patients without contraindications for surgery. The criteria by which patients are selected for an elective cholecystectomy are unclear. The aim of the present study was to establish the proportion of patients for whom a "wait-and-see" strategy was advised and to determine which, if any, patient characteristics had influenced this decision. This study included 71 patients, all younger than 80 years of age, with both CBD stones and a gallbladder containing stones in whom endoscopic clearance of bile duct stones was achieved. Three patients underwent a cholecystectomy within 1 week because of acute cholecystitis. Among the remaining 68 patients, cholecystectomy was recommended for 42 patients and a wait-and-see strategy was advised for 26 patients. Patient characteristics were identical in both groups except for the American Society of Anesthesiologists Physical Status (ASA) score. The ASA score was higher in the wait-and-see group, but 69% of the patient...Continue Reading

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Feb 22, 2001·American Journal of Surgery·D RutledgeR Rege
Dec 16, 2004·Critical Care Medicine·Avery B NathensCarl S Waldmann
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Nov 1, 2002·Scandinavian Journal of Gastroenterology. Supplement·Y C A KeulemansG P van Berge Henegouwen

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