ArticleThe Indian journal of surgery2012
Asymptomatic Gallstones (AsGS) - To Treat or Not to?
Article in The Indian journal of surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- Impact of concomitant cholecystectomy during gastrectomy for gastric cancer on the postoperative quality of life.Surgery today · 2026Article
- Increase in acute pancreatitis, especially gallstone related, as the cause for emergency admissions: Temporal trend from Kashmir, India.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Observational
- Asymptomatic gallstone disease: Re-evaluating the threshold for surgical options in the era of precision medicine.World journal of gastrointestinal surgery · 2025Review
- Perforated Calculous Cholecystitis and Incidental Squamous Cell Carcinoma of the Gallbladder-A Complex Relationship with a Difficult Management in the Acute Setting.Medicina (Kaunas, Lithuania) · 2025Article
- Cracking the silent gallstone code: Wait or operate?World journal of clinical cases · 2024Article
- Article
- Acute pancreatitis: It can be the first sign of silent gallstones.Turkish journal of surgery · 2023Article
- Gallbladder cancer.Nature reviews. Disease primers · 2022Review
- Cholecystectomy for asymptomatic gallstones: Markov decision tree analysis.World journal of clinical cases · 2022Review
- Clinico-epidemiology and aetiopathogenesis of gallstone disease in the South Asian region: a scoping review protocol.BMJ open · 2022Article
- The Chile Biliary Longitudinal Study: A Gallstone Cohort.American journal of epidemiology · 2021Article
- Cholecystectomy for Complicated Gallbladder and Common Biliary Duct Stones: Current Surgical Management.Frontiers in surgery · 2020Review
- Massive gallstone in an asymptomatic Indigenous Canadian male: Case report and literature review.International journal of surgery case reports · 2020Article
- Bile duct injury outcomes following cholecystectomy: a cross sectional study.American journal of clinical and experimental immunology · 2020Article
- Bariatric Surgery Did Not Increase the Risk of Gallstone Disease in Obese Patients: a Comprehensive Cohort Study.Obesity surgery · 2019Article
- Multimodality management of incidentally detected gall bladder cancer: long term results from a tertiary care cancer centre.Journal of gastrointestinal oncology · 2019Article
- Quality of Life in Patients with Background of Iatrogenic Bile Duct Injury.World journal of surgery · 2018Article
- Is Concomitant Cholecystectomy Necessary for Asymptomatic Cholelithiasis During Laparoscopic Sleeve Gastrectomy?Obesity surgery · 2018Article
- Gastric Bypass and Synchronous Cholecystectomy: a Matter of Numbers?Obesity surgery · 2017Article
- Tokyo Guidelines 2013 may be too restrictive and patients with moderate and severe acute cholecystitis can be managed by early cholecystectomy too.Surgical endoscopy · 2017Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
With ready availability of abdominal ultrasound, asymptomatic gallstones (AsGS) are being diagnosed with increasing frequency. Management decisions need to take into account the natural history of AsGS as well as the risks of cholecystectomy. Long-term follow up studies from the West have consistently shown that only a small minority of asymptomatic gallstones lead to development of symptoms or complications. Some sub-groups of patients (eg those with chronic hemolytic syndromes) have been shown to be at a higher risk of developing symptoms and complications and prophylactic cholecystectomy has been advised for them. Clear division of patients into low or high risk categories is still far from ideal and better identification of risk factors and risk stratification is needed. Overall, both open and laparoscopic cholecystectomy, are generally safe procedures. However, the incidence of bile duct injury (with all its serious consequences) continues to be higher with laparoscopic cholecystectomy and this should receive due consideration before offering prophylactic cholecystectomy to an asymptomatic patient who is not expected to receive any clinical benefit from it. Gallbladder cancer is rare in most of the developed world and prophylactic cholecystectomy has generally not been recommended to prevent development of GBC. Considering the wide geographical/ethnic variation in incidence of GBC across the world and the strong association of GBC with gallstones, it may not be prudent to extrapolate the results of studies of natural history of AsGS from one part of the world to another. Since northern India has one of the highest incidences of GBC in the world, it is imperative to have data on natural history of AsGS in patients from this area to allow formulation of precise guidelines for management of AsGs.
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