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Posted on Mon, 1 Aug 2022
Question: You are smart doctor !
I need your consultation about gallstones !

1. one article it is said - that over 20 -30 year asymptomatic less than 2% could develop developing biliary pancreatitis
Question - thous are who developed symptoms during time ? As in all literature where ir read asymptomatic XXXXXXX duct is not associated with complications

Over a 20- or 30-year period, the risk of developing biliary pancreatitis in patients with asymptomatic gallstones is not likely to be greater than 2%.
https://www.gastrojournal.org/article/S0016-5085(00)70122-3/fulltext

2. As symptoms gallstones starts thous who are diagnosed and early treated complications could be prevented ? if cholecystectomy is done and gallstones bile duct treatment is done !

3. if the treatment of after acute gallstone Acute Pancreatitis is done by bout cholecystectomy and bile duct treatment (ERCP) then Acute Pancreatitis recurrence risk is close to 0 %

As there are different study wit different recurrence rate

it this study recurrence was recurrence was 19.7 % - but
but may delay intervention to until after a further episode of pancreatitis or cloud the possibility of a biliary cause (as it said in study ) so

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

if bouth are treated then recurrence of acute pancreatitis should be low !
Logic ?

thanks
doctor
Answered by Dr. Raju A.T (15 hours later)
Brief Answer:
multifactorial

Detailed Answer:
Hi,

Thanks for your query.

1. Yes, Asymptomatic are the ones where one does not present any sort of pain or discomfort in the right hypochondrium or around that area, no jaundice, no dyspepsia secondary to bile duct inflammation etc. In these cases, either the stones in the duct might not be big enough to cause physical symptoms but over long run when not attended can lead to long-term inflammation and complications.

2. Yes, Symptomatic people do present early to the clinic. Diagnosis is made at the earliest and hence the treatment. Not only Cholecystectomy even medications with bile acid supplements can help prevent complications.

3. Yes, Cant say close to zero. The inflammation caused by the stone prior to removal could have started a chain of events that can lead to pancreatitis even after removal of the stone. But certainly, it is low.

The population considered in any study matters most. There are numerous factors that influence the recurrence like obesity , life style, diet etc which has to be made note of.

Hope, I answered your query.

wish you good health.

regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Raju A.T

General & Family Physician

Practicing since :2008

Answered : 4854 Questions

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You Are Smart Doctor ! I Need Your Consultation About

Brief Answer: multifactorial Detailed Answer: Hi, Thanks for your query. 1. Yes, Asymptomatic are the ones where one does not present any sort of pain or discomfort in the right hypochondrium or around that area, no jaundice, no dyspepsia secondary to bile duct inflammation etc. In these cases, either the stones in the duct might not be big enough to cause physical symptoms but over long run when not attended can lead to long-term inflammation and complications. 2. Yes, Symptomatic people do present early to the clinic. Diagnosis is made at the earliest and hence the treatment. Not only Cholecystectomy even medications with bile acid supplements can help prevent complications. 3. Yes, Cant say close to zero. The inflammation caused by the stone prior to removal could have started a chain of events that can lead to pancreatitis even after removal of the stone. But certainly, it is low. The population considered in any study matters most. There are numerous factors that influence the recurrence like obesity , life style, diet etc which has to be made note of. Hope, I answered your query. wish you good health. regards,