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July 18, 1966

Gallstones: A Therapeutic Dilemma

JAMA. 1966;197(3):26. doi:10.1001/jama.1966.03110030024012

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(Continued from page 24) mild and nonspecific symptoms and urge operation strongly for typical and/or severe symptoms."

Dr. Rhoads, who is professor of surgery at the University of Pennsylvania Medical School, reasoned that a broad policy of eliminating all gallstones, "say at age 50," is not very practical.

It might be wise, he suggested, to categorize the finding of stones which bring about the therapeutic dilemma into (1) radio-opaque stones discovered incidentally in the course of some other x-ray examination and (2) those found by cholecystogram or cholangiogram.

Even here, he said, the situation bringing about the examination may have been suggestive enough to make the finding of gallstones more than truly incidental.

If no other therapeutic approach appears clearly indicated and if the patient is a good risk, recommendation of biliary tract surgery would seem reasonable, he said.

But in the case of a truly incidental finding, he continued,

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