Asymptomatic cholelithiasis: when make surgery?

Detalhes bibliográficos
Autor(a) principal: Nunes, Sergio Ibañez
Data de Publicação: 2008
Outros Autores: Pinto, Carolina de Mendonça Brandão, Lima, Eduardo Cardozo, Ferreira Fernandes, Carolaine Bitencourt, Pereira, Geysler Aurélio, Neto, José Antônio Chehuen
Tipo de documento: Artigo
Idioma: por
Título da fonte: HU Revista (Online)
Texto Completo: https://periodicos.ufjf.br/index.php/hurevista/article/view/69
Resumo: The cholelithiasis can present itself in three ways: asymptomatic, symptomatic and complicated. The conduct in asymptomatic patients is often controversial. With the aim of identifying the conduct of gastroenterologists and surgeons facing the diagnosis of asymptomatic cholelithiasis and establish a consensus, sent a questionnaire with 21 questions to 23 gastroenterologists, 108 surgeons and 101 surgeons general of the digestive tract. Participants in the study agreed on the indication of cholecystectomy in the following questions: diagnostic ultrasound of cholelithiasis; gallstones below 0.5 cm, and above 2cm; gallbladder in porcelain; patients below 20 years; carriers of sickle cell anemia and diabetes and the concomitant laparotomy because no biliary, using the same incision. Only surgeons general and the digestive tract indicate cholecystectomy: in asymptomatic patients over 60 years, in morbidly obese, in the presence of two or more risk factors for cholelithiasis; abdominal surgery with the need to enlarge the incision; in patients with dyspeptics symptoms and normal endoscopy, refractory to clinical treatment or with atypical symptoms, in women with prospect of future pregnancies and as the wish of the patient. In asymptomatic patients over 70 years, only the surgeons of the digestive tract indicate cholecystectomy. Professionals agree to the non-cholecystectomy indication of the candidates for liver transplantation. We note, therefore, that there is agreement on the conduct of the 21 questions in 11 surveyed (52.3%), with divergence in the remaining items (47.7%). Thus, in agreement with the literature, it is not yet possible to establish a consensus for treatment of cholelithiasis asymptomatic.
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spelling Asymptomatic cholelithiasis: when make surgery?Colelitíase assintomática: quando operar?Colelitíase/cirurgiaTratamentoThe cholelithiasis can present itself in three ways: asymptomatic, symptomatic and complicated. The conduct in asymptomatic patients is often controversial. With the aim of identifying the conduct of gastroenterologists and surgeons facing the diagnosis of asymptomatic cholelithiasis and establish a consensus, sent a questionnaire with 21 questions to 23 gastroenterologists, 108 surgeons and 101 surgeons general of the digestive tract. Participants in the study agreed on the indication of cholecystectomy in the following questions: diagnostic ultrasound of cholelithiasis; gallstones below 0.5 cm, and above 2cm; gallbladder in porcelain; patients below 20 years; carriers of sickle cell anemia and diabetes and the concomitant laparotomy because no biliary, using the same incision. Only surgeons general and the digestive tract indicate cholecystectomy: in asymptomatic patients over 60 years, in morbidly obese, in the presence of two or more risk factors for cholelithiasis; abdominal surgery with the need to enlarge the incision; in patients with dyspeptics symptoms and normal endoscopy, refractory to clinical treatment or with atypical symptoms, in women with prospect of future pregnancies and as the wish of the patient. In asymptomatic patients over 70 years, only the surgeons of the digestive tract indicate cholecystectomy. Professionals agree to the non-cholecystectomy indication of the candidates for liver transplantation. We note, therefore, that there is agreement on the conduct of the 21 questions in 11 surveyed (52.3%), with divergence in the remaining items (47.7%). Thus, in agreement with the literature, it is not yet possible to establish a consensus for treatment of cholelithiasis asymptomatic.A colelitíase pode apresentar-se de três formas: assintomática, sintomática e complicada. A conduta nos pacientes assintomáticos é frequentemente controversa. Com o objetivo identificar as condutas de gastroenterologistas e cirurgiões frente ao diagnóstico de colelitíase assintomática e estabelecer um consenso, foi enviado um questionário com 21 quesitos a 23 gastroenterologistas, 108 cirurgiões gerais e 101 cirurgiões do aparelho digestivo. Os participantes do estudo concordaram quanto à indicação de colecistectomia nos seguintes quesitos: diagnóstico ultra-sonográfico de colelitíase; cálculos abaixo de 0,5cm, assim como acima de 2cm; vesícula em porcelana; pacientes abaixo de 20 anos; portadores de anemia falciforme e diabetes e concomitante à laparotomia por causa não biliar, utilizando a mesma incisão. Apenas cirurgiões gerais e do aparelho digestivo indicam colecistectomia: nos pacientes assintomáticos acima de 60 anos; na presença de obesidade mórbida, de dois ou mais fatores de risco para calculose; na cirurgia abdominal com necessidade de ampliar a incisão; nos pacientes com sintomas dispépticos e endoscopia normal, refratários ao tratamento clínico ou com sintomas atípicos; na mulher com perspectiva de futura gravidez e conforme o desejo do paciente. Em pacientes assintomáticos acima de 70 anos, apenas os cirurgiões do aparelho digestivo indicam colecistectomia. Os profissionais concordam com a não-indicação de colecistectomia nos candidatos a transplante hepático. Verificamos, portanto, que há concordância na conduta em 11 dos 21 quesitos pesquisados (52,3%), havendo divergência nos itens restantes (47,7%). Deste modo, em concordância com a literatura, ainda não ser possível estabelecer um protocolo de condutas frente à colelitíase assintomática que satisfaça a clínicos e cirurgiões.Editora UFJF2008-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionArtOrapplication/pdfhttps://periodicos.ufjf.br/index.php/hurevista/article/view/69HU Revista; v. 33 n. 3 (2007); 71-751982-80470103-3123reponame:HU Revista (Online)instname:Universidade Federal de Juiz de Fora (UFJF)instacron:UFJFporhttps://periodicos.ufjf.br/index.php/hurevista/article/view/69/46Nunes, Sergio IbañezPinto, Carolina de Mendonça BrandãoLima, Eduardo CardozoFerreira Fernandes, Carolaine BitencourtPereira, Geysler AurélioNeto, José Antônio Chehueninfo:eu-repo/semantics/openAccess2023-05-04T03:53:15Zoai:periodicos.ufjf.br:article/69Revistahttps://periodicos.ufjf.br/index.php/hurevistaPUBhttps://periodicos.ufjf.br/index.php/hurevista/oairevista.hurevista@ufjf.edu.br1982-80470103-3123opendoar:2023-05-04T03:53:15HU Revista (Online) - Universidade Federal de Juiz de Fora (UFJF)false
dc.title.none.fl_str_mv Asymptomatic cholelithiasis: when make surgery?
Colelitíase assintomática: quando operar?
title Asymptomatic cholelithiasis: when make surgery?
spellingShingle Asymptomatic cholelithiasis: when make surgery?
Nunes, Sergio Ibañez
Colelitíase/cirurgia
Tratamento
title_short Asymptomatic cholelithiasis: when make surgery?
title_full Asymptomatic cholelithiasis: when make surgery?
title_fullStr Asymptomatic cholelithiasis: when make surgery?
title_full_unstemmed Asymptomatic cholelithiasis: when make surgery?
title_sort Asymptomatic cholelithiasis: when make surgery?
author Nunes, Sergio Ibañez
author_facet Nunes, Sergio Ibañez
Pinto, Carolina de Mendonça Brandão
Lima, Eduardo Cardozo
Ferreira Fernandes, Carolaine Bitencourt
Pereira, Geysler Aurélio
Neto, José Antônio Chehuen
author_role author
author2 Pinto, Carolina de Mendonça Brandão
Lima, Eduardo Cardozo
Ferreira Fernandes, Carolaine Bitencourt
Pereira, Geysler Aurélio
Neto, José Antônio Chehuen
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Nunes, Sergio Ibañez
Pinto, Carolina de Mendonça Brandão
Lima, Eduardo Cardozo
Ferreira Fernandes, Carolaine Bitencourt
Pereira, Geysler Aurélio
Neto, José Antônio Chehuen
dc.subject.por.fl_str_mv Colelitíase/cirurgia
Tratamento
topic Colelitíase/cirurgia
Tratamento
description The cholelithiasis can present itself in three ways: asymptomatic, symptomatic and complicated. The conduct in asymptomatic patients is often controversial. With the aim of identifying the conduct of gastroenterologists and surgeons facing the diagnosis of asymptomatic cholelithiasis and establish a consensus, sent a questionnaire with 21 questions to 23 gastroenterologists, 108 surgeons and 101 surgeons general of the digestive tract. Participants in the study agreed on the indication of cholecystectomy in the following questions: diagnostic ultrasound of cholelithiasis; gallstones below 0.5 cm, and above 2cm; gallbladder in porcelain; patients below 20 years; carriers of sickle cell anemia and diabetes and the concomitant laparotomy because no biliary, using the same incision. Only surgeons general and the digestive tract indicate cholecystectomy: in asymptomatic patients over 60 years, in morbidly obese, in the presence of two or more risk factors for cholelithiasis; abdominal surgery with the need to enlarge the incision; in patients with dyspeptics symptoms and normal endoscopy, refractory to clinical treatment or with atypical symptoms, in women with prospect of future pregnancies and as the wish of the patient. In asymptomatic patients over 70 years, only the surgeons of the digestive tract indicate cholecystectomy. Professionals agree to the non-cholecystectomy indication of the candidates for liver transplantation. We note, therefore, that there is agreement on the conduct of the 21 questions in 11 surveyed (52.3%), with divergence in the remaining items (47.7%). Thus, in agreement with the literature, it is not yet possible to establish a consensus for treatment of cholelithiasis asymptomatic.
publishDate 2008
dc.date.none.fl_str_mv 2008-02-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv https://periodicos.ufjf.br/index.php/hurevista/article/view/69
url https://periodicos.ufjf.br/index.php/hurevista/article/view/69
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://periodicos.ufjf.br/index.php/hurevista/article/view/69/46
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dc.publisher.none.fl_str_mv Editora UFJF
publisher.none.fl_str_mv Editora UFJF
dc.source.none.fl_str_mv HU Revista; v. 33 n. 3 (2007); 71-75
1982-8047
0103-3123
reponame:HU Revista (Online)
instname:Universidade Federal de Juiz de Fora (UFJF)
instacron:UFJF
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instacron_str UFJF
institution UFJF
reponame_str HU Revista (Online)
collection HU Revista (Online)
repository.name.fl_str_mv HU Revista (Online) - Universidade Federal de Juiz de Fora (UFJF)
repository.mail.fl_str_mv revista.hurevista@ufjf.edu.br
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