Six hundred patients with gallstones

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Hepatobiliary Surgery

Background:

• Gallstones are a common condition with varied presentations and treatment modalities.
• Differentiating between gallbladder stones and common bile duct stones is crucial for appropriate management.
• Treatment strategies have evolved over time, influenced by patient demographics and procedural advancements.

Purpose of the Study:

• To analyze treatment trends and outcomes for gallstone disease over an 8-year period.
• To compare the safety and efficacy of different interventions for gallstones.
• To investigate the relationship between patient age and the type of gallstone presentation and treatment.

Main Methods:

• Retrospective analysis of 610 patients treated for gallstones over 8 years.
• Categorization of treatments: cholecystectomy, surgical duct exploration, and endoscopic sphincterotomy.
• Data collection on patient demographics, stone location, treatment modality, and mortality.

Main Results:

• A significant shift towards endoscopic sphincterotomy for duct stones was observed, increasing from 20% to 75%.
• Cholecystectomy resulted in a 1% mortality rate; no deaths occurred following treatment for duct stones.
• Elderly patients (>75 years) predominantly had duct stones treated with endoscopic sphincterotomy, while younger patients typically underwent surgical treatment for gallbladder stones.

Conclusions:

• Endoscopic sphincterotomy is a safe and effective primary treatment for common bile duct stones, particularly in the elderly.
• Cholecystectomy remains a viable option for gallbladder stones with low associated mortality.
• Treatment strategies for gallstones should be tailored based on stone location and patient age, reflecting evolving clinical practice.