Gallstones

doi:10.1136/bmj.39267.452257.AD

BMJ 2007;335:295-299 (11 August), doi:10.1136/bmj.39267.452257.AD

Clinical Review

Gallstones

Grant Sanders, locum consultant laparoscopic upper gastrointestinal surgeon, Andrew N Kingsnorth, professor of surgery at Peninsula Medical School

Department of Upper Gastrointestinal Surgery, Derriford Hospital, Plymouth PL6 8DH

Correspondence to: G Sanders gsanders@doctors.org.uk

The first 150 words of the full text of this article appear below.

• Of the adult Western population, 10-15%will develop gallstones, with between 1% and 4% a year developingsymptoms

• The incidence of gallstones increases withage, with family history being an important risk factor

•People with asymptomatic gallstones develop gallstone relatedproblems at a rate of 1%-4% a year, with small stones beingmore dangerous than large as they can cause pancreatitis

•Ursodeoxycholic acid does not reduce symptoms from gallstonesbut may be useful in preventing their formation in high riskgroups

• Percutaneous cholecystostomy is a good treatmentfor patients at high surgical risk

• Day case laparoscopiccholecystectomy should be the default for elective procedures.

•Cholecystectomy should be performed on the index admission forbiliary symptoms

About 10-15% of the adult Western population will develop gallstones,with between 1% and 4% a year developing symptoms.¹ From April2005 to March 2006, 49 077 cholecystectomy . . . [Full text of this article]

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Article was disappointing: M C Bateson
BMJ 2007 335: 362. [Extract] [Full Text] [PDF]

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Rapid Responses:

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Optimising management of emergency patients with symptomatic gall stones:: Amit Sinha
bmj.com, 13 Aug 2007 [Full text]
What about ERCP in the management of gallstones?: Miles C Allison
bmj.com, 13 Aug 2007 [Full text]
due recognition must be made of atypical presentations of choledocholithiasis: oscar,m jolobe
bmj.com, 14 Aug 2007 [Full text]
Managing Gallstones: M.C. Bateson
bmj.com, 15 Aug 2007 [Full text]
Features of pain in gallstone disease and Is gallstone ileus a misnomer?: Anton E Joseph
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MRCP and ERCP are cornerstones of gallstone management: Tom J W Lee, et al.
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Imaging in acute cholecystitis and gall stone ileus: Anton E Joseph
bmj.com, 15 Aug 2007 [Full text]
Imaging of Gallstones: David C Howlett
bmj.com, 21 Aug 2007 [Full text]
Re: What about ERCP in the management of gallstones?: Grant Sanders
bmj.com, 22 Aug 2007 [Full text]
Re: Imaging of Gallstones: NAZAR R DESSOUKI
bmj.com, 23 Aug 2007 [Full text]
Gallstone Ileus: Jit R Parmar
bmj.com, 23 Aug 2007 [Full text]
Gallstones: Why are doctors so poor at recognising biliary colic?: Heather I Lewis, et al.
bmj.com, 28 Aug 2007 [Full text]
Managing gallstones. Don't forget ERCP.: Juliette K Loehry, et al.
bmj.com, 30 Aug 2007 [Full text]
Follow-up after laparoscopic cholecystectomy: Rhys T Jones, et al.
bmj.com, 11 Oct 2009 [Full text]