A knowledge of the predictive factors of the development and persistence of symptoms in gallstone patients plays a key role in clinical decision making.
Dr Davide Festi and colleagues from Italy evaluated the presence of predictive factors for biliary pain development in gallstones, stressing the role of gallbladder motility.
A total of 153 patients with gallstones, of which 104 women and 49 men.
Gallbladder motility was evaluated by ultrasonography.
The research team evaluated biliary symptoms using a specific questionnaire in all gallstones at baseline and after 4 years of follow-up.
|Biliary pain developed more frequently in recent epdisodes|
|The American Journal of Gastroenterology|
At enrolment, the researchers identified 61 patients with recent, and 31 with remote episodes of biliary pain.
The team noted that 61 patients were asymptomatic.
At baseline, recent gallstones showed a greater percentage emptying, and a smaller residual volume than both remote episodes and asymptomatics.
After follow-up, the team noted that biliary pain developed more frequently in recent epdisodes, than in remote episodes and asymptomatic patients.
A high percentage emptying, and a small residual volume as predictive factors of biliary pain.
The researchers found that a history of biliary pain was a risk factor.
Dr Festi's colleagues concludes, “Efficient gallbladder motility is present in symptomatic gallstones."
"Efficient gallbladder motility represents a risk factor for biliary pain development, while sluggish motility seems to play a protective role.”
“Thus, gallbladder motility evaluation is a useful diagnostic tool in clinical decision making for gallstones.”
“In symptomatic gallstones, a progressive reduction of gallbladder motility could suggest a ‘wait and see' management policy instead of an immediate surgical approach.”