TAILIEUCHUNG - WGO Practice Guideline: Asymptomatic gallstone disease

Document introduction of content: Definitions, gallstone prevalence, follow-up and risks of complications, surgical treatment policy, exceptions, literature references, links to useful websites, WGO practice guidelines committee members who helped with this Guideline, queries and Feedback from you. | WGO Practice Guideline Asymptomatic Gallstone Disease Core Team Prof. Alan G. Johnson MD Prof. M Fried MD Prof. . Tytgat MD Drs. . Krabshuis Special Advisors Prof. Roque Saenz Prof. Martin Carey Prof. Sum P. Lee Sections 1. Definitions 2. Gallstone prevalence 3. Follow-up and risks of complications 4. Surgical treatment policy 5. Exceptions 6. Literature references 7. Links to useful websites 8. WGO Practice Guidelines Committee Members who helped with this Guideline 9. Queries and Feedback from You 1. Definitions Asymptomatic Gallstones the presence of gallstones detected incidentally in patients who do not have any abdominal symptoms or have symptoms that are not thought to be due to gallstones. Diagnosis is made during routine ultrasound for other abdominal conditions or occasionally by palpation of the gall bladder at operation. This definition implies that we know which symptoms are specific to gallstones. Gallstone symptoms 1 5 6 Pain at right hypochondrium or epigastrium often radiating to the right shoulder forcing the patient to rest and not relieved by bowel movement. Most commonly the pain is constant not colicky. The Danish prevalence study identified right upper quadrant pain during the night as the most discriminating symptom in men and strong and oppressive pain provoked by fatty meals as the symptom best correlating with the presence of gallstones in women 7 . Many patients present with vague indigestion and bloating which are more likely to be related to irritable bowel syndrome. However sometimes it is very difficult to decide whether gallstones are or are not causing the symptoms. For example the location of the pain is often epigastric and this may be misinterpreted as peptic ulcer disease particularly if the pain comes on after meals and at night. 2. Gallstone prevalence In Europe about 10 of all adults have gallstones with women having 3 times the prevalence of men during the fertile period 2 9 . Overall the prevalence in women is .

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• WGO Practice Guideline
• Asymptomatic gallstone disease
• follow up and risks of complications
• Literature references
• Links to useful websites
• Gallstone prevalence
• Introduction & key points
• Management of strongyloidiasis
• Disease burden & endemicity
• Diagnosis and differential diagnosis
• Avoiding needlestick injury
• Needle stick injury
• Accidental exposure to blood
• Avoiding infection
• Implementation and registration
• Osteoporosis and gastrointestinal diseases
• Gastrointestinal diseases
• Management of osteoporosis
• Consensus statements