Is Endoscopic Sphincterotomy an Adequate Treatment for Symptomatic Gall Stone in Bile Duct in Elderly Patients with an Asymptomatic Gall Bladder?
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2014, Vol 2, Issue 5
Abstract
The management of symptomatic gall bladder is well defined. However, treatment of symptomatic gallstone disease with an asymptomatic gall bladder is still controversial. This study looks at the need for routine cholecystectomy in elderly patients (>70 years old) within this clinical group. The study was a retrospective review of all Endoscopic cholangiopancreatography (ERC) and endoscopic sphincterotomy (ES) procedures from endoscopy data base. Of 928 ERC examinations 16 patients were identified for further study (Patients > 70 years old, asymptomatic gall bladders and where a conservative management had been undertaken). Average age was 74.5 years old and they all represented a significant operative risk. ERC and ES were successful in treating all patients and after a mean follow up of 17 month (Range 5 – 56 months) only 3 patients went on to require cholecystectomy at a later date due to symptomatic gall bladder. This study suggests that ERC and ES is sufficient treatment in elderly patients with symptomatic gallstone in the bile duct with an asymptomatic gall bladders, and questions the need for routine cholecystectomy. Keywords: CBD stones, ERCP, Cholangitis,Pancreatitis, High risk patients
Authors and Affiliations
Amir Hussain
Keywords
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