| Natural history of gallstone disease: Expectant management or active treatment? Results from a population-based cohort study. | |
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MedLine Citation:
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PMID: 20492328 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND AIMS: The knowledge of natural history is essential for disease management. We evaluated the natural history (e.g. frequency and characteristics of symptoms and clinical outcome) of gallstones (GS) in a population-based cohort study. METHODS: A total of 11 229 subjects (6610 men, 4619 women, age-range: 29-69 years, mean age: 48 years) were studied. At ultrasonography, GS were present in 856 subjects (338 men, 455 women) (7.1%). GS were followed by means of a questionnaire inquiring about the characteristics of specific biliary symptoms. RESULTS: At enrollment, 580 (73.1%) patients were asymptomatic, 94 (11.8%) had mild symptoms and 119 (15.1%) had severe symptoms. GS patients were followed up for a mean period of 8.7 years; 63 subjects (7.3%) were lost to follow up. At the end of the follow up, of the asymptomatic subjects, 453 (78.1%) remained asymptomatic; 61 (10.5%) developed mild symptoms and 66 (11.4%) developed severe symptoms. In subjects with mild symptoms, the symptoms disappeared in 55 (58.5%), became severe in 23 (24.5%), remained stable in 16 (17%); in subjects with severe symptoms, the symptoms disappeared in 62 (52.1%), became mild in 20 (16.8%) and remained stable in 37 (31.1%). A total of 189 cholecystectomies were performed: 41.3% on asymptomatic patients, 17.4% on patients with mild symptoms and 41.3% on patients with severe symptoms. CONCLUSIONS: This study indicates that: (i) asymptomatic and symptomatic GS patients have a benign natural history; (ii) the majority of GS patients with severe or mild symptoms will no longer experience biliary pain; and (iii) a significant proportion of cholecystectomies are performed in asymptomatic patients. Expectant management still represents a valid therapeutic approach in the majority of patients. |
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Authors:
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Davide Festi; Maria Letizia Bacchi Reggiani; Adolfo F Attili; Paola Loria; Paolo Pazzi; Eleonora Scaioli; Simona Capodicasa; Ferdinando Romano; Enrico Roda; Antonio Colecchia |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: Journal of gastroenterology and hepatology Volume: 25 ISSN: 1440-1746 ISO Abbreviation: J. Gastroenterol. Hepatol. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-05-24 Completed Date: 2010-08-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8607909 Medline TA: J Gastroenterol Hepatol Country: Australia |
Other Details:
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Languages: eng Pagination: 719-24 Citation Subset: IM |
Affiliation:
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Department of Clinical Medicine, University of Bologna, Bologna, Italy. davide.festi@unibo.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Chi-Square Distribution Cholecystectomy / adverse effects Cross-Sectional Studies Disease Progression Female Gallstones / complications, epidemiology*, surgery, ultrasonography Humans Italy / epidemiology Logistic Models Male Middle Aged Patient Selection Population Surveillance Questionnaires Recurrence Risk Assessment Risk Factors Severity of Illness Index Time Factors Treatment Outcome |
| Comments/Corrections | |
Comment In:
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J Gastroenterol Hepatol. 2010 Apr;25(4):651-2
[PMID:
20492320
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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