title: A 24-year controlled follow-up of patients with silent gallstones showed no long-term risk of symptoms or adverse events leading to cholecystectomy.
abstract: BACKGROUND
  The fate of asymptomatic gallstones has not been investigated in many studies with a long-term follow-up. We wanted to examine the subsequent rate of cholecystectomy and gallstone-related symptoms in a population examined in 1983.
  
  
  METHODS
  Among the persons examined in 1983, unknown (perceived as silent) gallstones were discovered in 20.1% (285/1417) persons. Owing to technical reasons, only 89.9% (1274 persons) of the original study population was retrieved for the present study. Of these, 19.2% (245 persons) had gallstones in 1983 [135 women (55.1%) and 110 men (44.9%), mean age in 1983: 49.9 and 51.3 years, respectively].
  
  
  RESULTS
  Of the 154 still living persons with gallstones from 1983, 134 were traced for follow-up. Of these, 89 underwent a clinical examination and 45 answered a mail or telephone questionnaire. Ultrasonography revealed gallstones in 28.1% (25/89) and 6.7% (9/134) had had the gallbladder removed. 5.5% (5/91) of the deceased patients had had a cholecystectomy. Overall cholecystectomy rate was 6.2%. No link could be shown between the number and the size of gallstones in 1983 and the ultrasonographic demonstration of gallstones in 2007. 43.8% had abdominal pain, and 29.2% had functional abdominal complaints.
  
  
  CONCLUSIONS
  Unexpectedly, only a minority of persons examined with ultrasonography had present day gallstones without any obvious explanation for this low figure. The rate of cholecystectomy was low in a conservative setting and no adverse events could be ascertained from such a policy.
authors.affiliation: Department of Surgery, Haraldsplass Deaconal Hospital, Bergen, Norway.
authors.forename: Malte
authors.initials: M
authors.lastname: Schmidt
authors.forename: Trygve
authors.initials: T
authors.lastname: Hausken
authors.forename: Inge
authors.initials: I
authors.lastname: Glambek
authors.forename: Christoph
authors.initials: C
authors.lastname: Schleer
authors.forename: Geir Egil
authors.initials: GE
authors.lastname: Eide
authors.forename: Karl
authors.initials: K
authors.lastname: Søndenaa
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D058070:Asymptomatic Diseases; D002763:Cholecystectomy / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011795:Surveys and Questionnaires; D014463:Ultrasonography