Living with gallstones? What does medical research tell us скачать в хорошем качестве

Living with gallstones? What does medical research tell us

Living with gallbladder problems? This video looks at scientific evidence around whether gallstones can be left untreated and what happens to such people? People with gallstones that are problematic may not have access to surgery or may not wish to have surgery or may not be fit to have surgery. This video reviews published evidence about people who do not have surgery for gallstones and just live with them once they cause symptoms. The results are surprising and maybe not what you would expect? saboorkhan.co.uk 00:00 Anatomy 00:58 Gallstones but no symptoms 01:17 Gallstones with symptoms but no complications 02:27 Gallstones with complications 03:06 Gallstones and risk of cancer The randomised trial mentioned in the video: Symptomatic, non-complicated gallbladder stone disease. Operation or observation? A randomized clinical study M Vetrhus 1, O Søreide, J H Solhaug, I Nesvik, K Søndenaa PMID: 12190099 Background: Cholecystectomy has been recognized as the treatment of choice for symptomatic gallbladder stone disease. Not all patients are cured by an operation and the reason for having the gallbladder removed may rest on common practice rather than evidence-based medicine. The aim was to compare cholecystectomy with observation (watchful waiting) in patients with uncomplicated symptomatic GBS disease. Three-hundred-and-thirty-eight patients were considered for participation in the study; 45 patients were excluded according to predefined criteria and 156 did not join for other reasons. The remaining 137 were randomized to cholecystectomy (n = 68) or non-operative, expectant treatment (n = 69). Conclusions: We found that non-operative expectant treatment carries a low risk of complications. Patients should be informed that watchful waiting is a safe option. Systematic review of the clinical and cost effectiveness of cholecystectomy versus observation/conservative management for uncomplicated symptomatic gallstones or cholecystitis Miriam Brazzelli 1, Moira Cruickshank, Mary Kilonzo, Irfan Ahmed, Fiona Stewart, Paul McNamee, Andy Elders, Cynthia Fraser, Alison Avenell, Craig Ramsay Affiliations expand • PMID: 25119541   • DOI: 10.1007/s00464-014-3712-6 Abstract Background: Gallstone disease is a common gastrointestinal disorder in industrialised countries. Although symptoms can be severe, some people can be symptom free for many years after the original attack. Surgery is the current treatment of choice, but evidence suggests that observation is also feasible and safe. We reviewed the evidence on cholecystectomy versus observation for uncomplicated symptomatic gallstones and conducted a cost-effectiveness analysis. Methods: We searched six electronic databases (last search April 2014). We included randomised controlled trials (RCTs) or non-randomised comparative studies where adults received either cholecystectomy or observation/conservative management for the first episode of symptomatic gallstone disease (biliary pain or cholecystitis) being considered for surgery in secondary care. Meta-analysis was used to combine results. Conclusions: Cholecystectomy is the preferred treatment for symptomatic gallstones. However, approximately half the observation group did not require surgery or suffer complications indicating that it may be a valid alternative to surgery. A multicentre trial is needed to establish the effects, safety and cost effectiveness of observation/conservative management relative to cholecystectomy.