One of the most common types of surgery done in the United States is the removal of the gallbladder. But many people who would benefit most from having their gallbladder removed don't get the surgery.
Now there is a model that surgeons can use to predict who is at the greatest risk and thus more likely to benefit the most from gallbladder surgery. The model was created by researchers at the University of Texas Medical Branch (UTMB) in Galveston. They found that a combination of factors-including age, sex, race, and other illnesses and severity of gallbladder disease-put a patient at the greatest risk for a gallbladder attack.
They have put the model to the test. The researchers went over 11 years worth of billing records for more than 160,000 patients age 66 and older who had had an initial problem with gallstones at UTMB. They used the predictive model to divide the patients into low, moderate, and high risk for an acute gallbladder attack, one serious enough to need hospitalization.
It turned out that the model found that the patients in the highest risk category didn't have their gallbladders removed any more than anyone else. Only about 22 percent of people in the low-risk group, 21 percent in the moderate-risk group, and 23 percent in the high-risk group had their gallbladder removed within a few months of their first gallbladder attack. The predicted risk of further gallbladder trouble to these patients had no influence on the decision whether to have the gallbladder removed.
The researchers stated that using their model to predict who is at greatest risk for further gallbladder problems could improve the outcome for older patients who have had gallstones.
The study was published in the January issue of the Journal of the American College of Surgeons.