REPLY
Is Gallbladder Function a Predictor of Outcome?
David F. Ransohoff, MD, and
Willam A. Gracie, MD
15 March 1994 | Volume 120 Issue 6 | Pages 523-524
IN RESPONSE:
Few data exist as to whether the functional status of the gallbladder, as measured by opacification during oral cholecystography or by ultrasonography with cholecystokinin, predicts biliary problems in persons with asymptomatic gallstones. In recent reports of 5- to 8-year follow-up of 116 persons with silent gallstones in Rome [1] and of 10-year follow-up of 110 persons in Sirmione, Italy [2], gallbladder nonvisualization was not a predictor of subsequent biliary symptoms. However, the number of study patients was small. Nevertheless, even if the prognosis in such persons were more serious than for others with asymptomatic gallstones, it would probably not be as severe as for persons with symptomatic gallstones for whom prophylactic treatment still provides little if any benefit [3]. For these reasons, we do not advocate assessing gallbladder function in persons with asymptomatic gallstones.
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Author and Article Information
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The University of North Carolina at Chapel Hill; Chapel Hill, NC 27599-7105
Ann Arbor, MI 48104
1. Attili AF, Capri R, Repice AM, Maselli J, The GREPCO Group. The natural history of gallstones: the GREPCO experience. In: Capocaccia L, Ricci G, Angelico F, Angelico M, Attili AF, Lalloni F, eds. Recent Advances in the Epidemiology and Prevention of Gallstone Disease. Dordrecht: Kluwer; 1991:47-50.
2. Sama C, Morselli-Labate AM, Venturoli N, Puci A, Banterle C, Barbara L. The natural history of asymptomatic and symptomatic gallstones: 10 year follow-up in the Sirmione study (Abstract). Hepatology. 1992; 16:87A.
3. Ransohoff DF, Gracie WA. Treatment of gallstones. Ann Intern Med. 1993; 119:606-19.
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