| Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age? | |
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MedLine Citation:
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PMID: 21938444 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND AND AIMS: Although patients with cholecystocholedocholithiasis are generally referred to cholecystectomy after endoscopic sphincterotomy (ES) and common bile duct clearance, we often have a conflict whether cholecystectomy is necessary in very elderly patients with comorbid diseases. The aim of this study is to assess whether cholecystectomy in very elderly patients is justified after ES. PATIENTS AND METHODS: Patients with cholecystocholedocholithiasis who underwent ES and stone extraction and were followed-up for more than 10 years were retrospectively reviewed. We divided these patients into two groups: the elderly group (equal to or more than 80 years old) and young group (less than 80 years old) and compared late biliary complications and mortality. RESULTS: The 10-year cumulative incidence of overall biliary complications was significantly lower in cholecystectomized patients than in patients with gallbladder in situ in the young group (7.5 vs. 21.7%, p = 0.0037), but not different in the elderly group (8.3 vs. 7.4%, p = 0.92). When each complication was evaluated separately, the rate of recurrent common bile duct stones (CBDS) was not different, but that of acute cholecystitis was significantly lower in the elderly group than in the young group (4.1 vs. 22.6%, p = 0.011). CONCLUSIONS: In very elderly patients the incidence of acute cholecystitis is low even when the gallbladder is preserved after endoscopic treatment of CBDS, with a similar risk of CBDS recurrence. Thus, it may not be necessary to recommend cholecystectomy after ES for CBDS in very elderly patients. |
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Authors:
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Takaharu Yasui; Shunichi Takahata; Hiroshi Kono; Yosuke Nagayoshi; Yasuhisa Mori; Kosuke Tsutsumi; Yoshihiko Sadakari; Takao Ohtsuka; Masafumi Nakamura; Masao Tanaka |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-22 |
Journal Detail:
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Title: Journal of gastroenterology Volume: - ISSN: 1435-5922 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9430794 Medline TA: J Gastroenterol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, 812-8582, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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