 |
|
Gallstones and Laparoscopic Cholecystectomy
NIH Consensus Development Panel on Gallstones and Laparoscopic Cholecystectomy;
John L. Gollan, MD, PhD, FRCP;
Gregory B. Bulkley;
Anna Mae Diehl, MD;
Janet D. Elashoff, PhD;
Michael P. Federle, MD;
Walter J. Hogan, MD;
Keith A. Kelly, MD;
David L. Massanari, MD;
Don W. Powell, MD;
Michael Sorrell, MD;
Joanne A. P. Wilson, MD;
Jeffrey S. T. Barkun, MD, FRCSC;
Eric B. Bass, MD, MPH;
Harvey Bernard, MD;
David L. Carr-Locke, MD, FRCP;
Robert J. Fitzgibbons, Jr, MD;
Gary D. Friedman, MD;
Thomas R. Gadacz, MD;
Alan F. Hofmann, MD, PhD;
John G. Hunter, MD;
Charles K. McSherry, MD;
William C. Meyers, MD;
Frank G. Moody, MD;
David L. Nahrwold, MD;
Douglas O. Olsen, MD;
Carlos A. Pellegrini, MD;
Jacques Perissat, MD;
Joseph B. Petelin, MD;
Edward H. Phillips, MD;
Henry A. Pitt, MD;
Leslie J. Schoenfield, MD, PhD;
Nathaniel J. Soper, MD;
Steven M. Strasberg, MD, FRCSC;
L. William Traverso, MD;
John V. White, MD;
Karl A. Zucker, MD;
Sarah C. Kaiser, PhD;
Elsa A. Bray;
Bejamin T. Burton, PhD;
David L. Carr-Locke, MD, FRCP;
James Everhart, MD, MPH;
John H. Ferguson, MD;
Willis R. Foster, MD;
Thomas K. Gadacz, MD;
John L. Gollan, MD, PhD, FRCP;
William H. Hall;
Frank A. Hamilton, MD;
Jay H. Hoofnagle, MD;
William Meyers, MD;
Leslie J. Schoenfield, MD, PhD;
Steven M. Strasberg, MD, FRCSC
JAMA. 1993;269(8):1018-1024.
|
|
| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
|
|
|
APPROXIMATELY 10% to 15% of the adult population or more than 20 million people in the United States have gallstones. It is estimated that there are about 1 million newly diagnosed patients annually. The prevalence is higher in women, in association with multiple pregnancies, obesity, and rapid weight loss, as well as in older patients and in certain ethnic groups. In 1991, approximately 600 000 patients underwent cholecystectomy. As a cause of hospitalization, gallstones are the most common and most costly digestive disease, with an annual estimated overall cost of more than $5 billion.
In humans, gallstones are composed principally of cholesterol, with pigment stones occurring less commonly. The formation of cholesterol stones is believed to result from the occurrence of cholesterol supersaturation, accelerated cholesterol crystal nucleation, and impaired gallbladder motility. Stones tend to grow for the first 2 to 3 years, at which point growth tends to stabilize; 85%
. . . [Full Text PDF of this Article]
Author Affiliations
| |
Panel and Conference Chairperson, Associate Professor of Medicine, Harvard Medical School, Director, Division of Gastroenterology, Brigham and Women's Hospital, Boston, Mass; Mark M. Ravitch Professor of Surgery, Director of Surgical Research, Johns Hopkins Medical Institutions, Baltimore, Md; Associate Professor, Division of Gastroenterology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md; Director, Division of Biostatistics, Department of Medicine, Cedars-Sinai Medical Center, Adjunct Professor of Biomathematics, UCLA Medical Center, Los Angeles, Calif; Professor of Radiology, University of Pittsburgh (Pa) J. Michael Henderson, MD, FRCS, Chairman, Department of General Surgery, The Cleveland (Ohio) Clinic Foundation, Cleveland; Professor of Medicine, Medical College of Wisconsin, Co-Director, Division of Gastroenterology, Froedbert Memorial Lutheran Hospital, Milwaukee; Professor and Chairman, Department of Surgery, Mayo Medical School, Mayo Clinic and Foundation, Rochester, Minn; Private Practice, Family Medicine and Geriatrics, Sanford Family Health Care, PA, Sanford, Me; Edward Randall and Edward Randall Jr Professor, Chairman, Department of Internal Medicine, University of Texas Medical Branch, Galveston Layton F. Rikkers, MD, Merle M. Musselman Professor and Chairman, Department of Surgery, University of Nebraska Medical Center, Omaha; Robert L. Grissom Professor of Medicine, Medical Director, Liver Transplant Program, University of Nebraska Medical Center, Omaha Thelma King Thiel, RN, President and Chief Operating Officer, American Liver Foundation, Cedar Grove, NJ; Associate Professor of Medicine, Associate Chief of Outpatient Services, Division of Gastroenterology, Duke University Medical Center, Durham, NC; "Laparoscopic Versus Mini-Cholecystectomy: Canadian Experience"; "Cost-Effectiveness of Laparoscopic Cholecystectomy Versus Open Cholecystectomy"; "Complications After Laparoscopic Cholecystectomy" Martin C. Carey, MD, DSc, FRCPI: "Pathogenesis of Gallstones"; "Gallstone Pancreatitis: Endoscopy" Peter B. Cotton, MD, FRCP: "Treatment of Choledocholithiasis: Endoscopic Management"; "Gallbladder and Gallstone Removal, Open Versus Closed Laparoscopy, and Pneumoperitoneum"; "Natural History of Asymptomatic and Symptomatic Gallstones"; "Laparoscopic Cholecystectomy: US Experience"; "Primary Prevention of Symptomatic Cholesterol Gallstone Disease"; "Exposure, Dissection, and Electrocautery vs Laser for Performance of Laparoscopic Cholecystectomy"; "Open Cholecystectomy"; "Complications of Laparoscopic Cholecystectomy"; "Lithotripsy in the Treatment of Biliary Stones"; "Gallstone Lithotripsy"; "Mini-lap Cholecystectomy: Is Smaller Better?"; "Gallstone Pancreatitis: Surgery"; "Laparoscopic Cholecystectomy: European Experience"; "Laparoscopic Approach to Common Duct Pathology"; "Routine vs Selective Cholangiography"; "Open Choledochostomy"; "Oral and Contact Dissolution of Gallstones"; "Nonbiliary Problems Impacting on Laparoscopic Cholecystectomy"; "Overview of Treatments for Cholesterol Gallstones"; "Clinical Manifestations and Impact of Gallstone Disease"; "The National Laparoscopic Surgery Registry: Assessment of Laparoscopic Cholecystectomy and the Future of Laparoscopic Surgery"; "Laparoscopic Management of Acute Cholecystitis"; Planning Committee Chairperson, Program Director, Liver, Biliary, and Pancreatic Diseases, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Program Analyst, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Associate Director for Disease Prevention and Technology Transfer, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Associate Professor of Medicine, Harvard Medical School, Director of Endoscopy, Endoscopy Center, Brigham and Women's Hospital, Boston, Mass; Medical Officer, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Director, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Senior Staff Physician, Office of Disease Prevention and Technology Transfer, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Professor and Chairman, Department of Surgery, Medical College of Georgia, Augusta; Associate Professor of Medicine, Harvard Medical School, Director, Division of Gastroenterology, Brigham and Women's Hospital, Boston, Mass; Director of Communications, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Program Director, Gastrointestinal Digestive Diseases, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Director, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Professor of Surgery and Chief of Gastrointestinal Surgery, Director of Liver Transplantations, Duke University Medical Center, Durham, NC; Director of Gastroenterology, Cedars-Sinai Medical Center, Professor of Medicine, UCLA School of Medicine, Los Angeles, Calif; Professor of Surgery, Washington University School of Medicine, St Louis, Mo
From the Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md.
Footnotes
NIH Consensus Development Conferences are convened to evaluate available scientific information and to resolve safety and efficacy issues related to a biomedical technology. The resultant NIH Consensus Statements are intended to advance understanding of the technology or issue in question and to be useful to health professionals and the public.
NIH Consensus Statements are prepared by a nonadvocacy, nonfederal panel of experts based on (1) presentations by investigators working in areas relevant to the consensus questions during a 1 -day public session; (2) questions and statements from conference attendees during open discussion periods that are part of the public session; and (3) closed deliberations by the panel during the remainder of the second day and the morning of the third day. This statement is an independent report of the panel and is not a policy statement of the NIH or the federal government.
Reprint requests to Office of Medical Applications of Research, Federal Bldg, Room 618, National Institutes of Health, Bethesda, MD 20892 (William H. Hall). Bibliography, prepared by the National Library of Medicine, is available from the same address.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
|
