The best management for 'crescendo biliary colic' is urgent laparoscopic cholecystectomy

Gallbladder disease due to stones is well recognised as falling into two categories, presenting with either chronic symptoms or developing acute cholecystitis or other complications. We describe an intermediate group of 14 patients (11 women, three men, median age 31 years) presenting with 4-14 days...

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Bibliographic Details
Published in:Postgraduate medical journal 1998-11, Vol.74 (877), p.681-682
Main Authors: Robertson, G. S., Wemyss-Holden, S. A., Maddern, G. J.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cholecystectomy, Laparoscopic
Cholelithiasis - surgery
Colic - surgery
Emergencies
Female
Humans
Liver, biliary tract, pancreas, portal circulation, spleen
Male
Medical sciences
Middle Aged
Prospective Studies
Recurrence
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
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Summary:Gallbladder disease due to stones is well recognised as falling into two categories, presenting with either chronic symptoms or developing acute cholecystitis or other complications. We describe an intermediate group of 14 patients (11 women, three men, median age 31 years) presenting with 4-14 days of at least daily attacks of resolving biliary colic, who underwent early laparoscopic cholecystectomy within 24 hours of presentation. None had any evidence of acute inflammation, either at laparoscopy or on histology. Their surgery was straightforward with operating times ranging from 35-80 minutes and no complications. Patients with 'crescendo biliary colic' are often young women who can rarely afford invalidity. Rather than the current practice of analgesia for each attack and elective surgery weeks later, they are optimally managed by urgent laparoscopic cholecystectomy, preventing the development of complications and minimising the need for further medical involvement.
ISSN:0032-5473
1469-0756
DOI:10.1136/pgmj.74.877.681