Frequency of Cholecystectomy and Investigation of Related Factors in Asymptomatic Gallstones

Abstract

Purpose: While cholecystectomy is recommended for the treatment of symptomatic gallstones in current guidelines, surgery is not recommended in asymptomatic cases. In this study, we aimed to investigate the frequency of cholecystectomy and the factors affecting the approach to asymptomatic gallstones in clinical practice.

Material and Methods: This study was designed as a prospective survey study. In this study, cases who had undergone cholecystectomy for gallstones in the past were evaluated. The survey was administered by face-to-face interview method and each patient was asked questions about surgical indication, medical information and symptoms.

Results: In this study (n=212); 75 (35.4%) cases had asymptomatic gallstones and were operated on for prophylactic purposes; 137 (64.6%) cases were found to have been operated on due to certain indications (presence of dyspeptic symptoms, acute cholecystitis, porcelain gallbladder, etc.). In the surgical decision with inappropriate indication; it was observed that the departments of general surgery (64%), internal medicine (29.3%) and gastroenterology (4%) played a role. However, in some of the cases; it was found that dyspeptic complaints such as abdominal pain, bloating, nausea and epigastric burning continued after the surgery.

Conclusion: Today, inappropriate surgical treatment in asymptomatic gallstones is common, and approximately one out of every three patients is decided to undergo surgery. Therefore, it is considered that the medical and legal adverse situations that may occur can be prevented by reconsidering the issue by the relevant fields of speciality

Keywords

• acute cholecystitis
• cholecystectomy
• asymptomatic gallstones

Asemptomatik Safra Taşlarında Kolesistektomi Sıklığı ve İlişkili Faktörlerin Araştırılması

Abstract

Amaç: Güncel rehberlerde semptomatik safra taşlarının tedavisinde kolesistektomi önerilirken asemptomatik olgularda cerrahi önerilmemektedir. Bu çalışmada, klinik pratikte asemptomatik safra taşlarına yaklaşımda kolesistektomi sıklığı ve etki eden faktörlerin araştırılması amaçlanmıştır.

Araçlar ve Yöntem: Bu çalışma prospektif, kesitsel nitelikte ve tanımlayıcı bir anket çalışması olarak tasarlanmıştır. Çalışmada kapsamında geçmişte safra taşı nedeni ile kolesistektomi uygulanan olgular değerlendirilmiştir. Yüz yüze görüşme yöntemi ile uygulanan ankette başlıca; cerrahi endikasyon, tıbbi bilgilendirme ve semptom değişimi yönünden bilgiler değerlendirilmiştir

Bulgular: Bu çalışmada kolesistektomi endikasyonları incelendiğinde; 75 (%35.4) olguda asemptomatik safra taşı olduğu ve profilaksi amaçlı opere edildiği; 62 (%29.2) olgu akut kolesistit, 6 (%2.8) olgu koledokolitiyazis, 1 (%0.5) olgu porselen kese, 3 (%1.4) olgu akut pankreatit, 2 (%0.9) olgu polip birlikteliği ve 63 (%29.7) olgunun ise semptomatik safra taşı nedeniyle opere edildiği belirlendi. Uygun olmayan endikasyonla cerrahi kararı verilmesinde; %64 ile genel cerrahi, %29.3 ile iç hastalıkları ve %4 ile gastroenteroloji bölümleri gözlendi.

Sonuç: Asemptomatik safra taşlarında endikasyon dışı cerrahi tedavi uygulanması günümüzde sık görülen bir durumdur. Bu nedenle konunun ilgili branşlar tarafından yeniden ele alınarak oluşabilecek tıbbi ve hukuki olumsuz durumların önlenebileceği değerlendirilmektedir.

Keywords

• akut kolesistit
• asemptomatik safra taşı
• kolesistektomi

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