Cholecystectomy versus no cholecystectomy in patients with silent gallstones

Abstract

Background: Cholecystectomy is currently advised only for patients with symptomatic gallstones. However, about 4% of patients with asymptomatic gallstones develop symptoms including cholecystitis, obstructive jaundice, pancreatitis, and gallbladder cancer. Objectives: To assess the benefits and harms of surgical removal of the gallbladder for patients with asymptomatic gallstones. Search strategy: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until 2006 for identifying the randomised trials using The Cochrane Hepato-Biliary Group search strategy. Selection criteria: Only randomised clinical trials (irrespective of language, blinding, or publication status) comparing cholecystectomy and no cholecystectomy were considered for the review. Data collection and analysis: We were unable to identify any randomised clinical trials comparing cholecystectomy versus no cholecystectomy. Main results: We were unable to identify any randomised clinical trial comparing cholecystectomy versus no cholecystectomy. Authors' conclusions: There are no randomised trials comparing cholecystectomy versus no cholecystectomy in patients with silent gallstones. Further evaluation of observational studies, which measure outcomes such as obstructive jaundice, gallstone-associated pancreatitis, and/or gall-bladder cancer for sufficient duration of follow-up is necessary before randomised trials are designed in order to evaluate whether cholecystectomy or no cholecystectomy is better for asymptomatic gallstones. Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.