Goswami AG, Basu S. Cracking the silent gallstone code: Wait or operate? World J Clin Cases 2024; 12(16): 2692-2697 [PMID: 38899308 DOI: 10.12998/wjcc.v12.i16.2692]
Corresponding Author of This Article
Somprakas Basu, MBBS, MS, MSc, FRCS, Professor and Head, Department of General Surgery, All India Institute of Medical Sciences, Virbhadra Road, Rishikesh 249203, Uttarakhand, India. somprakas.surg@aiimsrishikesh.edu.in
Research Domain of This Article
Surgery
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 6, 2024; 12(16): 2692-2697 Published online Jun 6, 2024. doi: 10.12998/wjcc.v12.i16.2692
Cracking the silent gallstone code: Wait or operate?
Aakansha Giri Goswami, Somprakas Basu
Aakansha Giri Goswami, Somprakas Basu, Department of General Surgery, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India
Author contributions: Basu S conceived the idea; Basu S and Goswami AG collected, analysed, interpreted the data, wrote and prepared the manuscript. All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest with any individual(s) or any organization.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Somprakas Basu, MBBS, MS, MSc, FRCS, Professor and Head, Department of General Surgery, All India Institute of Medical Sciences, Virbhadra Road, Rishikesh 249203, Uttarakhand, India. somprakas.surg@aiimsrishikesh.edu.in
Received: December 31, 2023 Revised: April 10, 2024 Accepted: April 18, 2024 Published online: June 6, 2024 Processing time: 149 Days and 18.3 Hours
Abstract
The widespread availability of abdominal ultrasound has revealed the common occurrence of asymptomatic gallstones. While the treatment for symptomatic gallstones is clear, the benefits of minimally invasive laparoscopic cholecystectomy have sparked debate about the best approach to managing silent gallstones. The potential for asymptomatic gallstones to become symptomatic or lead to complications complicates the decision-making process regarding surgical intervention, as it's uncertain when or which patients might develop complications. Consequently, risk stratification appears to play a critical role in guiding decisions about silent gallstones. However, there is no definitive evidence to direct management, and a consensus-based on high-quality evidence is yet to be established.
Core Tip: The discussion surrounding silent gallstones remains unresolved. Despite only approximately 20% of gallstones becoming symptomatic, the widespread use of abdominal ultrasounds, coupled with the availability of laparoscopic cholecystectomies and their quick recovery times, promotes the preemptive removal of asymptomatic gallstones. Patients often opt for surgery to avert future complications, including gallbladder cancer in certain areas. The likelihood of asymptomatic gallstones progressing to symptomatic disease is very low, and complications typically do not arise without symptoms. Given this and the absence of clear guidelines, there is a need for risk stratification to selectively manage those in high-risk groups with silent gallstones.
