Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2024; 12(1): 42-50
Published online Jan 6, 2024. doi: 10.12998/wjcc.v12.i1.42
Natural history of asymptomatic gallbladder stones in clinic without beds: A long-term prognosis over 10 years
Yuji Sakai, Toshio Tsuyuguchi, Hiroshi Ohyama, Junichiro Kumagai, Takashi Kaiho, Masayuki Ohtsuka, Naoya Kato, Tadao Sakai
Yuji Sakai, Tadao Sakai, Department of Gastroenterology, Sakai Clinic, Kimistu 299-1162, Japan
Yuji Sakai, Hiroshi Ohyama, Naoya Kato, Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan
Toshio Tsuyuguchi, Department of Gastroenterology, Chiba Prefectural Sawara Hospital, Chiba Prefectural Sawara Hospital, Sawara 287-0003, Japan
Junichiro Kumagai, Department of Gastroenterology, Kimitsu Central Hospital, Kisarazu 292-8535, Japan
Takashi Kaiho, Department of Surgery, Kimitsu Central Hospital, Kisarazu 292-8535, Japan
Masayuki Ohtsuka, Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan
Author contributions: Sakai Y, Ohtsuka M, Tsuyuguchi T, and Kato N were responsible for manuscript preparation; Sakai Y wrote the paper; Tsuyuguchi T and Sakai T revised the manuscript; Ohyama H, Kumagai J, and Kaiho T collected the references.
Institutional review board statement: A study at this clinic was conducted after obtaining approval from all patients about the use of data. We requested the Institutional Review Board at Chiba Prefectural Sawara Hospital to review data and obtained their approval (IRB No. 4-12).
Informed consent statement: In order to know the long-term prognosis, we confirmed the prognosis by directly calling the patient and the transportation hospitals in addition to the information at the outpatient clinic.
Conflict-of-interest statement: All authors declare having no conflicts of interest.
Data sharing statement: The data that support the findings of this study are available from the corresponding author, upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuji Sakai, MD, PhD, Doctor, Department of Gastroenterology, Sakai Clinic, 9-18-8 Minamikoyasu, Kimistu 299-1162, Japan. sakai4754@yahoo.co.jp
Received: September 3, 2023
Peer-review started: September 3, 2023
First decision: October 24, 2023
Revised: October 31, 2023
Accepted: December 18, 2023
Article in press: December 18, 2023
Published online: January 6, 2024
Abstract
BACKGROUND

Several studies have explored the long-term prognosis of patients with asymptomatic gallbladder stones. These reports were primarily conducted in facilities equipped with beds for addressing symptomatic cases.

AIM

To report the long-term prognosis of patients with asymptomatic gallbladder stones in clinics without bed facilities.

METHODS

We investigated the prognoses of 237 patients diagnosed with asymptomatic gallbladder stones in clinics without beds between March 2010 and October 2022. When symptoms developed, patients were transferred to hospitals where appropriate treatment was possible. We investigated the asymptomatic and survival periods during the follow-up.

RESULTS

Among the 237 patients, 214 (90.3%) remained asymptomatic, with a mean asymptomatic period of 3898.9279 ± 46.871 d (50-4111 d, 10.7 years on average). Biliary complications developed in 23 patients (9.7%), with a mean survival period of 4010.0285 ± 31.2788 d (53-4112 d, 10.9 years on average). No patient died of biliary complications.

CONCLUSION

The long-term prognosis of asymptomatic gallbladder stones in clinics without beds was favorable. When the condition became symptomatic, the patients were transferred to hospitals with beds that could address it; thus, no deaths related to biliary complications were reported. This finding suggests that follow-up care in clinics without beds is possible.

Keywords: Gallbladder stone, Acute cholangitis, Acute cholecystitis, Asymptomatic gallbladder stone, Symptomatic gallbladder stone

Core Tip: A long-term prognosis of asymptomatic gallbladder stones at a clinic without beds was favorable. Patients with asymptomatic gallbladder stones in a bedless clinic were well-cared for and had a long duration of no symptoms.