Our data suggest that are specific factors unique to patients who require long-term TPN that contribute to the increased mortality and morbidity associated with cholecystectomy in this select group.[以下，作者用较大篇幅分析了这类病人死亡率和并发症增高的临床、实验室和手术等方面的原因，说明为什么本研究报告的手术发病率和死亡率比其他研究报告的要高，原文从略]

　　Based on the results of our studies, we believe that early cholecystectomy is indicated in patients with TPN-induced gallbladder disease. Obviously, all patients with symptomatic disease should undergo cholecystectomy unless there specific medical contraindications. These operations should be performed in a timely, elective fashion because delay may result in the need for urgent surgery and thereby, increase an already high risk. Although recent studies have suggested that cholecystectomy may not be warranted in otherwise healthy patients with asymptomatic gallbladder disease [20], we believe that this axiom does not apply to patients with TPN-induced gallbladder disease. Out data suggest that the natural history of gallbladder disease in patients receiving TPN is considerably different from that of their counterparts not receiving TPN. Based on our findings, we recommend elective cholecystectomy in patients receiving TPN when gallstones first appear. Furthermore, cholecystectomy should be considered, especially in children without stones who are undergoing laparotomy for other reasons. 【从对结果的分析及与其他研究的比较得出结论性意见，这是讨论部分最重要的内容，也是摘要结论部分的基础 】 Whether TPN-induced gallstones can be prevented through daily stimulated gallbladder emptying awaits the results of further studies. 【前瞻研究，即对研究存在或新发现的问题】

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