The presentation of gallstones and results of biliary surgery in a spinal cord injured population

BACKGROUND: Since spinal cord injured patients lack visceral sensation, the ir clinical manifestations of gallstones could be relatively occult. A high er proportion of these individuals may present with advanced biliary diseas e compared with the general population. Prophylactic cholecystectomy for as ymptomatic stones may therefore be justified. METHODS: All spinal cord injured patients seen at the Seattle Veterans Hosp ital over a 5-year period were retrospectively surveyed to define a set of patients who had undergone a cholecystectomy. The operative indications and results were compared with those from a series of cholecystectomies in neu rologically intact patients. RESULTS: The presentation of biliary disease in spinal cord injured patient s was not more advanced than that of neurologically intact patients. Patien ts with high cord injuries presented in a similar fashion to those with low injuries. CONCLUSIONS: Since most spinal cord injured patients with biliary disease p resent with typical findings, prophylactic removal of gallstones in these p atients is not warranted. (C) 1999 by Excerpta Medica, Inc.