The many large series of gallbladder operations reported in the literature all show high percentages of cases in which no stones are found at operation. For the most part the ratio as shown by reports from different sources is fairly constant, stones being found in approximately 65 to 70 per cent of cases, while from 30 to 35 per cent are classified as cholecystitis without stones.
The hypothesis that cholecystitis is the real cause of the morbidities of gallbladder origin and that gallstones are only an incidental by-product has been comforting to many surgeons, but to me the problem of the stoneless gallbladder presenting no very clear-cut evidences of pathologic change has always remained an unsolved riddle. The literature on gallbladder surgery has not been particularly helpful because for the most part end-result reports have included only gallstone cases, or calculus and noncalculus cases have been grouped indiscriminately. In 1910,
STANTON EM. THE STONELESS GALLBLADDER: A STUDY OF POSTOPERATIVE END RESULTS. JAMA. 1926;87(26):2160–2162. doi:10.1001/jama.1926.02680260028011
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