Chronic acalculous gallbladder disease: a clinical variant.

Abstract:

:A review of 228 cholecystectomies done over a two-year period revealed 15 cases (6.6%) in which gallstones were absent. These 15 patients were all characterized by colicky abdominal pain in the right upper quadrant, with a mean duration of eight months. Ultrasonographic examination was falsely positive for gallstones in one third (5/15) of the patients, and further diagnostic evaluation in the remaining two thirds (10/15) failed to define a clear-cut surgical problem. All 15 patients ultimately had operation on the basis of symptoms. Every patient reported resolution of preoperative symptoms at short-term follow-up (four to eight weeks). Seven patients available for long-term follow-up (ten to 27 months) reported complete symptomatic resolution. The postoperative outcome failed to correlate reliably with gallbladder histology, bile cultures, and results of diagnostic testing. There was no mortality, and morbidity was limited to three patients. This series confirms previous reports of a small set of relatively young, healthy patients having chronic disabling symptoms of gallbladder disease in the absence of gallstones. Our results suggest that the most reliable factor predicting a successful outcome of cholecystectomy in these patients was the presence of severe biliary colic.

journal_name

South Med J

journal_title

Southern medical journal

authors

Frykberg ER,Duong TC,LaRosa JJ,Etienne HB

doi

10.1097/00007611-198811000-00005

subject

Has Abstract

pub_date

1988-11-01 00:00:00

pages

1353-7

issue

11

eissn

0038-4348

issn

1541-8243

journal_volume

81

pub_type

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