Expectant management of patients with gallbladder stones diagnosed at planned investigation. A prospective 5- to 7-year follow-up study of 153 patients.

Abstract

Few studies have been done on the expectant management of patients with cholelithiasis diagnosed by planned investigation, and results are conflicting. A prospective 6-year follow-up study of 153 patients with cholelithiasis diagnosed by oral cholecystography was carried out. An acute gallstone complication occurred during the follow-up period in 23 patients (15%)-that is, acute cholecystitis (n = 18), acute pancreatitis (n = 2), and jaundice (n = 3). The annual risk of developing an acute biliary complication was 3.1%. A history of a gallstone complication predicted further gallstone complications during follow-up. The overall cholecystectomy rate was 20 % during the 1st year but fell to about 3% during the 5th year of follow-up. Young age and frequent attacks of biliary pain episodes predicted the need for gallstone surgery. Expectant management of patients with electively diagnosed cholelithiasis may be justified, especially in those with only occasional biliary symptoms and no history of gallstone complications.