[What happens to gallstone patients discharged without cholecystectomy? Follow-up of 222 consecutive patients with initially untreated gallstones].
BACKGROUND
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.


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.


CONCLUSIONS
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.
Eriksen
Jens Ravn
JR
Glostrup Hospital, Kirurgisk Afdeling D. jravn@dadlnet.dk
Boel
Thomas
T
Schulze
Svend
S
Kristiansen
Viggo B
VB
D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000009:adverse effects / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000706:statistics & numerical data; D041761:Cholecystolithiasis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission; D017410:Practice Guidelines as Topic; D012042:Registries; D012307:Risk Factors