title: Long-term follow-up study of gallbladder in situ after endoscopic common duct stone removal in Korean patients.
abstract: BACKGROUND
  Although there has been much debate over the fate of the gallbladder (GB) after endoscopic common bile duct (CBD) stone removal, subsequent cholecystectomy is generally recommended in patients with GB stones to prevent further biliary complications. The aims of this study were to assess the natural course of the patients with GB in situ after endoscopic CBD stone removal and to evaluate the necessity of prophylactic cholecystectomy.
  
  
  METHODS
  Four hundred sixty-one patients who had undergone CBD stone removal at Yeungnam University Hospital between January 2000 and December 2004 were retrospectively analyzed, and 232 patients were ultimately enrolled in this study.
  
  
  RESULTS
  The mean duration of follow-up was 73 (range = 7-126) months in the cholecystectomy group and 66 (6-127) months in the GB in situ group (p = 0.168). Ten patients (14.7 %) in the cholecystectomy group and 31 patients (18.9 %) in the GB in situ group developed recurrent CBD stones (p = 0.295). The highest percentage of recurrent CBD stones in both groups was that for brown stones (80 and 80.6 %). In the GB in situ group, cumulative recurrence rates of CBD stones were not significantly different between patients with GB stones and without GB stones (15.9 vs. 20 %, p = 0.798). However, the incidence of acute cholecystitis was significantly higher in patients with GB stones compared to patients without GB stones (13.6 vs. 2.5 %, p = 0.003).
  
  
  CONCLUSIONS
  Prophylactic cholecystectomy seems to be unnecessary in patients without GB stones after endoscopic sphincterotomy. However, in patients with GB stones, elective cholecystectomy or close observation is recommended due to the higher risk of cholecystitis.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung 5-dong, Nam-gu, Daegu 705-717, Korea.
authors.forename: Mei Lan
authors.initials: ML
authors.lastname: Cui
authors.forename: Joon Hyun
authors.initials: JH
authors.lastname: Cho
authors.forename: Tae Nyeun
authors.initials: TN
authors.lastname: Kim
mesh_terms: D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D002764:Cholecystitis / Q000517:prevention & control; D002769:Cholelithiasis / Q000453:epidemiology / Q000517:prevention & control; D015897:Comorbidity; D003251:Constriction, Pathologic / Q000628:therapy; D004106:Dilatation; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder; D042882:Gallstones / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D019564:Unnecessary Procedures