title: Usefulness of gallbladder ejection fraction estimation to predict the recurrence of biliary pain in patients with symptomatic gallstones who did not undergo cholecystectomy.
abstract: This study was performed to evaluate any predictable factors associated with recurrence of biliary pain in symptomatic gallstone patients who did not undergo cholecystectomy because of operative risk, advanced age, and/or their refusal. The relationships among age, gender, body mass index, frequency of biliary pain before diagnosis, period between the last symptom attack and the hospital visit, size and number of gallstones, gallbladder ejection fraction (GBEF), compliance of ursodeoxycholic acid therapy, and recurrence of biliary pain were examined. The recurrence of biliary pain developed in 15 of 31 patients during the median 29-month follow-up. The cumulative 1-, 2-, and 3-year recurrence rates of biliary pain were 22.8, 40.9, and 53.0% and significantly associated with abnormal GBEF (hazard ratio, 3.12; 95% CI, 1.10-8.87; P = 0.032). In symptomatic gallstone patients with abnormal GBEF, cholecystectomy is strongly advisable because of the high risk of repeated pain attacks.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sung Noh
authors.initials: SN
authors.lastname: Hong
authors.forename: Jong Kyun
authors.initials: JK
authors.lastname: Lee
authors.forename: Kyu Taek
authors.initials: KT
authors.lastname: Lee
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Heo
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Poong Lyul
authors.initials: PL
authors.lastname: Rhee
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Paik
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoo
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Rhee
mesh_terms: D000328:Adult; D000368:Aged; D002763:Cholecystectomy; D041761:Cholecystolithiasis / Q000503:physiopathology* / Q000601:surgery; D003085:Colic / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D016473:Gallbladder Emptying / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence