The presentation of gallstones and results of biliary surgery in a spinal cord injured population

Background: Since spinal cord injured patients lack visceral sensation, their clinical manifestations of gallstones could be relatively occult. A higher proportion of these individuals may present with advanced biliary disease compared with the general population. Prophylactic cholecystectomy for as...

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Bibliographic Details
Published in:The American journal of surgery 1999-09, Vol.178 (3), p.246-250
Main Authors: Moonka, Ravi, Stiens, Steven A, Eubank, William B, Stelzner, Matthias
Format: Article
Language:English
Subjects:
Abdomen
Archives & records
Asymptomatic
Bile ducts
Biliary Tract Diseases - diagnosis
Biliary Tract Diseases - epidemiology
Blood
Calculi
Case-Control Studies
Cholecystectomy
Cholelithiasis - complications
Cholelithiasis - diagnosis
Cholelithiasis - epidemiology
Cholelithiasis - surgery
Colic - diagnosis
Colic - epidemiology
Elective surgery
Female
Gallbladder
Gallbladder diseases
Gallstones
Hospitals
Humans
Injuries
Leukocytes
Male
Medical records
Middle Aged
Morbidity
Pain
Pancreatitis
Paralysis
Patients
Retrospective Studies
Sensation
Spinal cord
Spinal cord injuries
Spinal Cord Injuries - complications
Surgical outcomes
Trauma
Ultrasonic imaging
Veterans
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Description
Summary:Background: Since spinal cord injured patients lack visceral sensation, their clinical manifestations of gallstones could be relatively occult. A higher proportion of these individuals may present with advanced biliary disease compared with the general population. Prophylactic cholecystectomy for asymptomatic stones may therefore be justified. Methods: All spinal cord injured patients seen at the Seattle Veterans Hospital over a 5-year period were retrospectively surveyed to define a set of patients who had undergone a cholecystectomy. The operative indications and results were compared with those from a series of cholecystectomies in neurologically intact patients. Results: The presentation of biliary disease in spinal cord injured patients was not more advanced than that of neurologically intact patients. Patients with high cord injuries presented in a similar fashion to those with low injuries. Conclusions: Since most spinal cord injured patients with biliary disease present with typical findings, prophylactic removal of gallstones in these patients is not warranted.
ISSN:0002-9610
1879-1883
DOI:10.1016/S0002-9610(99)00164-6