title: The presentation of gallstones and results of biliary surgery in a spinal cord injured population.
abstract: BACKGROUND
  Since spinal cord injured patients lack visceral sensation, their clinical manifestations of gallstones could be relatively occult. A higher proportion of these individuals may present with advanced biliary disease compared with the general population. Prophylactic cholecystectomy for asymptomatic stones may therefore be justified.
  
  
  METHODS
  All spinal cord injured patients seen at the Seattle Veterans Hospital over a 5-year period were retrospectively surveyed to define a set of patients who had undergone a cholecystectomy. The operative indications and results were compared with those from a series of cholecystectomies in neurologically intact patients.
  
  
  RESULTS
  The presentation of biliary disease in spinal cord injured patients was not more advanced than that of neurologically intact patients. Patients with high cord injuries presented in a similar fashion to those with low injuries.
  
  
  CONCLUSIONS
  Since most spinal cord injured patients with biliary disease present with typical findings, prophylactic removal of gallstones in these patients is not warranted.
authors.affiliation: Department of Surgery, Seattle Division of the Puget Sound Veterans Affairs Health Care System, University of Washington School of Medicine, USA.
authors.forename: R
authors.initials: R
authors.lastname: Moonka
authors.forename: S A
authors.initials: SA
authors.lastname: Stiens
authors.forename: W B
authors.initials: WB
authors.lastname: Eubank
authors.forename: M
authors.initials: M
authors.lastname: Stelzner
mesh_terms: D001660:Biliary Tract Diseases / Q000175:diagnosis / Q000453:epidemiology; D016022:Case-Control Studies; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D003085:Colic / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*