Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2022; 10(29): 10399-10412
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10399
Cholecystectomy for asymptomatic gallstones: Markov decision tree analysis
Brian Juin Hsien Lee, Qai Ven Yap, Jee Keem Low, Yiong Huak Chan, Vishal G Shelat
Brian Juin Hsien Lee, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore S308232, Singapore
Qai Ven Yap, Yiong Huak Chan, Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore S117597, Singapore
Jee Keem Low, Vishal G Shelat, Department of General Surgery, Tan Tock Seng Hospital, Singapore S308433, Singapore
Author contributions: Lee BJH performed the research; Shelat VG designed the research study; Low JK contributed towards expert opinion; Yap QV and Chan YH provided statistical assistance; Lee BJH and Shelat VG analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors have nothing to disclose.
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:
Corresponding author: Vishal G Shelat, MS, Adjunct Associate Professor, Department of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore S308433, Singapore.
Received: April 17, 2022
Peer-review started: April 17, 2022
First decision: May 12, 2022
Revised: May 13, 2022
Accepted: September 1, 2022
Article in press: Sepyember 1, 2022
Published online: October 16, 2022
Core Tip

Core Tip: We recommend that an option of cholecystectomy should be discussed with all asymptomatic gallstone patients. Disclosure of material information is essential for patients to make an informed choice for prophylactic cholecystectomy. It is for the patient to decide on watchful waiting or prophylactic cholecystectomy, and not for the medical community to make a blanket policy of watchful waiting for asymptomatic gallstone patients. For patients with high-risk profiles, it is clinically justifiable to advocate cholecystectomy to minimize the likelihood of morbidity due to complications.