| Topic: | Digestive Diseases (DD) |
| Title: | Gallstones, from Gallbladder to Gut: Management Options for Diverse Complications. |
| Author: | Agrawal, S.; Jonnalagadda, S. |
| Source: | Postgraduate Medicine. 108(3): 143-146, 149-153. September 1, 2000. |
| Availability: | Available from McGraw-Hill, Inc. 1221 Avenue of the Americas, New York, NY 10020. (612) 832-7869. |
| Abstract: | Gallstones may be incidental and asymptomatic or painful and accompanied by life threatening obstruction or infection. A thorough knowledge of potential complications is therefore critical, especially because some asymptomatic stones require prompt treatment. In this article, the authors offer guidelines for recognizing and treating the various manifestations of gallstone disease (cholelithiasis). Once the gallstones become symptomatic, surgical removal of the gallbladder (cholecystectomy) is usually recommended. Endoscopic retrograde cholangiopancreatography (ERCO) with sphincterotomy and stone extraction is performed if bile duct stones are evident on imaging studies or suspected on the basis of the clinical picture or liver enzyme abnormalities. In patients with cholangitis (a consequence of bacterial infection superimposed on an obstructed biliary system), the mainstay of therapy is biliary drainage, which should be performed as early as possible, even before determining and treating the cause of obstruction. In selected patients with gallstone pancreatitis, use of early ERCP, sphincterotomy, and stone extraction results in lower morbidity (illness) and mortality (death). Nonsurgical treatment is appropriate for patients with recurrent biliary colic or chronic cholecystitis (gallbladder infection), but not for those with acute cholecystitis. Recurrence rates are high with nonsurgical treatment. 3 figures. 29 references. |
| Format: | Journal Article |
| Language: | English. |
| Major Keywords: | Digestive System Diseases. Gallstones. Diagnosis. Therapy. Patient Selection. Complications. Symptoms. |
| Minor Keywords: | Diagnostic Tests. Risk Factors. Cholesterol. Biliary Tract Diseases. Cholangitis. Pancreatitis. Endoscopic Retrograde Cholangiopancreatography. Surgery. Drug Therapy. Dissolution Therapy. Abdominal Pain. Chronic Disease. Acute Disease. |
| Publication Number: | DDJA08022 |
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