Radiological aspects of nonsurgical therapy of gallbladder stones

In the western world gallstones are a common finding in adults. Epidemiologic studies in Italy [1-3] reported the prevalence of gallstones to be between 8.3% [1] and 13.9% [3]. The prevalence increases with age and is higher for females. Over the age of 50 years the prevalence is 10-15% for males and 20-25% for females [4]. Although 80% of the subjects with gallstones are free of symptoms [3], gallstone disease is a major health problem. It is reported to be one of the most common causes of hospitalization for surgical procedures [5]. In the United States 500,000 - 600,000 cholecystectomies are performed annually with an estimated cost of over 1 billion dollars [5]. Cholecystectomy has a hospital stay of approximately 5 days and a subsequent significant disability of 3-6 weeks. It is a safe and effective procedure and has been the standard therapy for more than 100 years. McSherry [6] recently reviewed records of more than 14,000 cases over half a century of surgically treated patients with gallstones. The total mortality rate was I. 7% with age being the most important risk factor. The mortality rate was 0.4% in patients under 50 years, !.5% in patients between 50 and 65 years and 4.5% in patients 65 years and older. When elective cholecystectomy was performed the mortality rate was 0.09% for patients under 50 years and 0.8% for patients over 50 years.

• View at Worldcat

Free Full Text ( Final Version , 3mb )