4 ms·

I don't think any surgeon in the industrialised world is removing an appendix or gallbladder today because they think it's useless, they're removing them becaus

I don't think any surgeon in the industrialised world is removing an appendix or gallbladder today because they think it's useless, they're removing them because they're trying to kill the patient

XorNot 3y ago
The other reason is if you're going to Antarctica (you can't go if you still have your appendix, because if something goes wrong there is very likely no way to casevac you fast enough that you won't die from it - same applies to astronauts).
- reducesuffering 3y ago
  > if something goes wrong there is very likely no way to casevac you fast enough that you won't die from it There is one other option that's been tried... https://en.wikipedia.org/wiki/Leonid_Rogozov https://en.wikipedia.org/wiki/Leonid_Rogozov
mauvia 3y ago
The ambiguous they makes this half as likely to read "They're (the surgeons) are removing them (the appendices) because they're (the surgeons) trying to kill the patient. It's funny.
agos 3y ago
inflamed appendices, sure. gallbladders are removed with a lot less care
- msla 3y ago
  While you might reliably survive attacks of biliary colic, you'll greatly wish you didn't have to. (I had my gallbladder removed many years ago.)
ho4 3y ago
Never implied that they did. However there are several common mild conditions to which the only option you'll get is removing them. For instance, a single gallbladder stone (instead of trying to dissolve it) or a mild state of appendicitis (the body can manage).
- robbiep 3y ago
  this is incorrect on a number of levels. there are well established criteria under which we will remove a gallbladder and a number of times where stones are found and we won't. If someone has an episode of Cholecystitis then the evidence clearly shows that the best thing for the patient is to have it taken out, because they're highly predisposed to get recurrent episodes which, despite being very painful and an acute danger to life, also leads to significant inflammation and scarring which makes eventually removing it down the line carry a higher burden of morbidity. Attempting to dissolve really only works on small stones but you have to ask people, if you're getting them now and you're predisposed to get them (either through genetics or diet) then do you want to go through repeated admissions and presentations and all the disruption to life just to keep your gallbladder for a while longer, when the data shows most of these patients will ultimately end up going through a cholecystectomy anyway? For mild appendicitis, the burden of evidence in the past 10 years has swung significantly towards managing mild appendicitis (whether confirmed on imaging or clinically diagnosed) with antibiotics which has a low but meaningful rate of repeat presentation of around 20%

I don't think any surgeon in the industrialised world is removing an appendix or gallbladder today because they think it's useless, they're removing them because they're trying to kill the patient

XorNot 3y ago

The other reason is if you're going to Antarctica (you can't go if you still have your appendix, because if something goes wrong there is very likely no way to casevac you fast enough that you won't die from it - same applies to astronauts).

reducesuffering 3y ago
> if something goes wrong there is very likely no way to casevac you fast enough that you won't die from it There is one other option that's been tried... https://en.wikipedia.org/wiki/Leonid_Rogozov https://en.wikipedia.org/wiki/Leonid_Rogozov

mauvia 3y ago

The ambiguous they makes this half as likely to read "They're (the surgeons) are removing them (the appendices) because they're (the surgeons) trying to kill the patient. It's funny.

agos 3y ago

inflamed appendices, sure. gallbladders are removed with a lot less care

msla 3y ago
While you might reliably survive attacks of biliary colic, you'll greatly wish you didn't have to. (I had my gallbladder removed many years ago.)

ho4 3y ago

Never implied that they did. However there are several common mild conditions to which the only option you'll get is removing them. For instance, a single gallbladder stone (instead of trying to dissolve it) or a mild state of appendicitis (the body can manage).

robbiep 3y ago
this is incorrect on a number of levels. there are well established criteria under which we will remove a gallbladder and a number of times where stones are found and we won't. If someone has an episode of Cholecystitis then the evidence clearly shows that the best thing for the patient is to have it taken out, because they're highly predisposed to get recurrent episodes which, despite being very painful and an acute danger to life, also leads to significant inflammation and scarring which makes eventually removing it down the line carry a higher burden of morbidity. Attempting to dissolve really only works on small stones but you have to ask people, if you're getting them now and you're predisposed to get them (either through genetics or diet) then do you want to go through repeated admissions and presentations and all the disruption to life just to keep your gallbladder for a while longer, when the data shows most of these patients will ultimately end up going through a cholecystectomy anyway? For mild appendicitis, the burden of evidence in the past 10 years has swung significantly towards managing mild appendicitis (whether confirmed on imaging or clinically diagnosed) with antibiotics which has a low but meaningful rate of repeat presentation of around 20%