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Gallbladder disease and cholecystectomy rate are independently variable.

M C Bateson

    Lancet (London, England)
    |September 15, 1984
    PubMed
    Summary

    Gallstones affect many in Britain, with gallbladder disease increasing. Gallstone complications and surgery posed significant mortality risks, independent of myocardial infarction or cholesterolosis.

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    Area of Science:

    • Gastroenterology
    • Epidemiology
    • Pathology

    Background:

    • Gallstones are highly prevalent in Britain, affecting 1 in 3 women and 1 in 5 men.
    • Gallbladder disease incidence and cholecystectomy rates have notably increased in Dundee and Scotland.
    • The rise in surgeries could not be attributed to increased gallbladder disease prevalence.

    Purpose of the Study:

    • To investigate mortality associated with gallstone disease and gallbladder surgery.
    • To examine the relationship between gallstones, gallbladder cholesterolosis, and myocardial infarction.
    • To determine the incidence of gallbladder carcinoma in necropsy cases.

    Main Methods:

    • Retrospective analysis of gallstone disease and gallbladder surgery outcomes in Dundee.
    • Necropsy data review for patients with gallstones, common bile duct stones, and gallbladder carcinoma.
    • Statistical comparison of mortality rates and disease associations.

    Main Results:

    • Between 1974-1983, 48 patients died from gallstone disease in Dundee.
    • Mortality was significantly higher in patients with common bile duct stones (41%) compared to gallbladder stones only (2.5%).
    • Gallbladder surgery without bile duct intervention resulted in 26 deaths; no association was found with myocardial infarction or cholesterolosis. Primary and secondary gallbladder carcinoma were identified in necropsy findings.

    Conclusions:

    • Gallstone disease, particularly with common bile duct involvement, carries a substantial mortality risk.
    • Gallbladder surgery also presents significant risks.
    • Gallbladder disease is not linked to myocardial infarction or cholesterolosis, but carcinoma of the gallbladder is a notable finding in necropsies.

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