Abstract
The clinical profiles of 139 patients with gallstones found coincidentally during ultrasonography were reviewed and the patients followed prospectively for five years. Indications for ultrasonography included follow-up of abdominal malignancy (33%), evaluation of abdominal aortic aneurysm or other arteriosclerotic vascular disease (22%), renal insufficiency (12%), and lower abdominal pain (7%). At the time of gallstone detection, 14 patients (10%) had symptoms attributable to cholelithiasis. Over the next five years, only 15 patients (11%) developed episodes resembling biliary pain. Nine patients underwent cholecystectomy during this period. Three of the cholecystectomies were incidental to other abdominal procedures. Two cholecystectomies were performed as emergencies for gallstone complications with no perioperative mortality. Interestingly, 54 patients (40%) with coincidental gallstones died during the follow-up period. All the deaths were unrelated to gallstones. These data indicate that Ultrasonographically detected coincidental gallstones rarely have clinical significance, lending strong support to the expectant management of most patients with purely coincidental gallstones.
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Birnholz JC: Population survey: Ultrasound cholecystography. Gastrointest Radiol 7:165, 1982
Chesson RR, Gallup DG, Jones BE, Thomas B: Ultrasonographic diagnosis of asymptomatic cholelithiasis in pregnancy. J Reprod Med 30:920–922, 1985
MacDonald FR, Cooperberg PL, Cohan MN: The WES triad. A specific sonographic sign of gallstones in the contracted gallbladder. Gastrointest Radiol 6:39–41, 1981
Raptopoulos V, D'Orsic C, Smith E, Reuter K, Moss L, Kleinman P: Dynamic cholecystosonography of the contracted gallbladder: The double-arc-shadow sign. AJR 138:275–278, 1982
Tucker L, Tangedahl TN: Manifestations of gallstone disease. Postgrad Med 66:179–184, 1979
Rome Group for the Epidemiology and Prediction of Cholelithiasis (Grepco): Prevalence of gallstone disease in an Italian adult female population. Am J Epidemiol 119:796–805, 1984
Thistle JL, Cleary PA, Lachin JM, Tyor MP, Hersh T: The Steering Committee and The National Cooperative Gallstone Study Group. The natural history of cholelithiasis. Ann Intern Med 101:171–175, 1984
McSherry CK, Ferstenberg N, Calhoun WF, Lahman E, Virshup M: The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients. Ann Surg 202:59–63, 1985
Gracie WA, Ransohoff DF: The natural history of select gallstones. The innocent gallstone is not a myth. N Engl J Med 307:798–800, 1982
Newman HF, Northup JO, Rosenblum M, Abrams H: Complications of cholelithiasis. Am J Gastroenterol 50:476–496, 1968
Barbara L, Sama C, Marselli-Labate AM, Taroni F, Rusticali AG, Festi D, Sapio C, Roda E, Banterle C, Puci A, Formentini F, Colasanti S, Nardin F: A population study on the prevalence of gallstone disease: The Sirmione study. Hepatology 7:913–917, 1987
Rome Group for the Epidemiology and Prediction of Cholelithiasis (Grepco): The epidemiology of gallstone disease in Rome, Italy. Part II. Factors associated with the disease. Hepatology 8:907–913, 1988
Thomson JS, Philben VJ, Hodgson PE: Operative management of incidental cholelithiasis. Am J Surg 148:821–824, 1984
Ouriel K, Ricotta JJ, Adams JT, Deweese JA: Management of cholelithiasis in patients with abdominal aortic aneurysm. Ann Surg 198:717–719, 1983
Kern F: Epidemiology and natural history of gallstones. Semin Liver Dis 3:87–96, 1983
Ransohoff DF, Gracie WA, Wolfenson LB, Neuhauser D: Prophylactic cholecystectomy or expectant management for silent gallstones. Ann Intern Med 99:199–204, 1983
Schreiber H, Macon WL, Pories WJ: Incidental cholecystectomy during major abdominal surgery in the elderly. Am J Surg 135:196–198, 1978
McSherry CK, Glen F: Biliary tract surgery concomitant with other intraabdominal operations. Ann Surg 193:169–175, 1981
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Cucchiaro, G., Rossitch, J.C., Bowie, J. et al. Clinical significance of ultrasonographically detected coincidental gallstones. Digest Dis Sci 35, 417–421 (1990). https://doi.org/10.1007/BF01536912
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DOI: https://doi.org/10.1007/BF01536912