Gallstones affect 20% of the Western population and will grow in clinical significance as obesity and metabolic diseases become more prevalent. Gallbladder removal (cholecystectomy) is a common treatment for diseases caused by gallstones, with 1.2 million surgeries in the US each year, each costing USD 10,000. Gallbladder disease has a significant impact on the logistics and economics of healthcare. We discuss the two most common presentations of gallbladder disease (biliary colic and cholecystitis) and their pathophysiology, risk factors, signs and symptoms. We discuss the factors that affect clinical care, including diagnosis, treatment outcomes, surgical risk factors, quality of life and cost-efficacy. We highlight the importance of standardised guidelines and objective scoring systems in improving quality, consistency and compatibility across healthcare providers and in improving patient outcomes, collaborative opportunities and the cost-effectiveness of treatment. Guidelines and scoring only exist in select areas of the care pathway. Opportunities exist elsewhere in the care pathway.
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http://dx.doi.org/10.3390/medicina58030388 | DOI Listing |
BMC Gastroenterol
January 2025
Department of Gastroenterology, The First Affiliated Hospital of Shihezi University, No.107 North Second Road, Hongshan Street, Shihezi, 832008, China.
Background: Gallbladder and biliary diseases (GABD) represent prevalent disorders of the digestive system.
Methods: Data on age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years (DALYs) rate (ASDR) were extracted from the Global Burden of Disease (GBD) 2021 study. The estimated annual percentage change (EAPC) was utilized to quantify temporal trends in GABD.
BMJ Case Rep
January 2025
Department of General Surgery, Ealing Hospital, London North West University Healthcare NHS Trust, London, UK.
We present a case of a woman in her 70s who arrived in the emergency department with signs of small-bowel obstruction. CT scanning revealed acute cholecystitis with a cholecystoduodenal fistula, pneumobilia and small-bowel obstruction possibly secondary to gallstone ileus although no radio-opaque gallstones were seen. The patient underwent an emergency operation and intra-operative findings revealed mechanical small-bowel obstruction of the proximal jejunum where a 4×2 x 3 cm gallstone was impacted.
View Article and Find Full Text PDFUlus Travma Acil Cerrahi Derg
January 2025
Interventional Radiology Department, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul-Türkiye.
Background: Acute cholecystitis (AC) is increasingly common and imposes a burden on healthcare systems, particularly in the elderly population. While laparoscopic cholecystectomy (LC) is the definitive treatment, percutaneous cholecystostomy (PC) is often preferred based on various factors. The treatment of elderly patients requires a multidisciplinary approach that carefully assesses surgical risks due to age-related changes and comorbidities.
View Article and Find Full Text PDFUlus Travma Acil Cerrahi Derg
January 2025
Department of General Surgery, Istanbul Training and Research Hospital, Istanbul-Türkiye.
Introduction: Gallstone may cause complications of cholecystitis, gallbladder gangrene, perforation, and related sepsis. This study aims to identify how CRP and immune cells change in patients with acute calculous cholecystitis based on the severity of disease.
Method: Patients with acute calculous cholecystitis were categorized into three main groups-mild, moderate, and severe-based on the Tokyo guidelines.
Medicina (Kaunas)
November 2024
HPB Unit, Department of Surgery, University Hospital of Ioannina, 455 00 Ioannina, Greece.
: Laparoscopic cholecystectomy (LC) is the most commonly performed operation in general surgery in the Western World. Gallbladder surgery, although most of the time simple, always offers the possibility of unpleasant surprises. Despite progress, the incidence of common bile duct injury is 0.
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