Asymptomatic cholelithiasis revisited
Elective cholecystectomy in the asymptomatic patient has elicited considerable controversy, going back to the prelaparoscopy cholecystectomy era. Surgical services often see patients with known or unidentified cholelithiasis who, having been asymptomatic, present with serious complications, potentia...
- Autores:
- Tipo de recurso:
- Fecha de publicación:
- 1998
- Institución:
- Universidad del Rosario
- Repositorio:
- Repositorio EdocUR - U. Rosario
- Idioma:
- eng
- OAI Identifier:
- oai:repository.urosario.edu.co:10336/26420
- Acceso en línea:
- https://doi.org/10.1007/s002689900530
https://repository.urosario.edu.co/handle/10336/26420
- Palabra clave:
- cholecystectomy
asymptomatic patient
prelaparoscopy
Surgical services
- Rights
- License
- Restringido (Acceso a grupos específicos)
Summary: | Elective cholecystectomy in the asymptomatic patient has elicited considerable controversy, going back to the prelaparoscopy cholecystectomy era. Surgical services often see patients with known or unidentified cholelithiasis who, having been asymptomatic, present with serious complications, potentially lethal, in whom emergency operations are associated with technical difficulties that lead to high conversion rates and significant mortality and morbidity. Elective cholecystectomy is a safe procedure associated with low morbidity and no mortality. Based on an analysis of our experience and a review of the literature, we discuss the indications for elective laparoscopic cholecystectomy in asymptomatic patients at high risk of developing complications of their asymptomatic disease. The following high-risk criteria are proposed for elective cholecystectomy: life expectancy > 20 years; calculi > 2 cm in diameter; calculi < 3 mm and a patent cystic duct; radiopaque calculi; polyps in the gallbladder (GB); nonfunctioning GB; calcified (“porcelain”) GB; concomitant diabetes; women < 60 years; and individuals in geographic regions with a high prevalence of GB cancer. |
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