Management of Asymptomatic Cholelithiasis

Asymptomatic gallstones are found in approximately 10%–20% of the adult population, with only 1%–4% developing symptoms annually. Although complications such as biliary colic, acute cholecystitis or pancreatitis may occur, the overall risk remains low. Laparoscopic cholecystectomy, though effective...

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Main Authors: Chiranjiva Khandelwal, Utpal Anand, Kislay Kant
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:NMO Journal
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Online Access:https://journals.lww.com/10.4103/JNMO.JNMO_10_25
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author Chiranjiva Khandelwal
Utpal Anand
Kislay Kant
author_facet Chiranjiva Khandelwal
Utpal Anand
Kislay Kant
author_sort Chiranjiva Khandelwal
collection DOAJ
description Asymptomatic gallstones are found in approximately 10%–20% of the adult population, with only 1%–4% developing symptoms annually. Although complications such as biliary colic, acute cholecystitis or pancreatitis may occur, the overall risk remains low. Laparoscopic cholecystectomy, though effective with a >95% success rate, carries a morbidity of ~2%–6% and a mortality risk of <0.5%, making routine surgery unwarranted in most asymptomatic individuals. Observation is recommended in most cases. Prophylactic cholecystectomy is considered for high-risk groups, including patients with gallstones >2–3 cm, those with sickle cell disease or candidates for bariatric or organ transplant surgery. While the risk of gall bladder cancer in asymptomatic cholelithiasis is <0.3%, enhanced surveillance is advised in regions with high cancer prevalence. Routine cholecystectomy for cancer prevention is not supported by current evidence.
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spelling doaj-art-451fab3a38094eb095f7e5144873344d2025-08-20T03:40:13ZengWolters Kluwer Medknow PublicationsNMO Journal2348-38062950-59332025-01-01191546010.4103/JNMO.JNMO_10_25Management of Asymptomatic CholelithiasisChiranjiva KhandelwalUtpal AnandKislay KantAsymptomatic gallstones are found in approximately 10%–20% of the adult population, with only 1%–4% developing symptoms annually. Although complications such as biliary colic, acute cholecystitis or pancreatitis may occur, the overall risk remains low. Laparoscopic cholecystectomy, though effective with a >95% success rate, carries a morbidity of ~2%–6% and a mortality risk of <0.5%, making routine surgery unwarranted in most asymptomatic individuals. Observation is recommended in most cases. Prophylactic cholecystectomy is considered for high-risk groups, including patients with gallstones >2–3 cm, those with sickle cell disease or candidates for bariatric or organ transplant surgery. While the risk of gall bladder cancer in asymptomatic cholelithiasis is <0.3%, enhanced surveillance is advised in regions with high cancer prevalence. Routine cholecystectomy for cancer prevention is not supported by current evidence.https://journals.lww.com/10.4103/JNMO.JNMO_10_25cholelithiasisgallstonemanagement
spellingShingle Chiranjiva Khandelwal
Utpal Anand
Kislay Kant
Management of Asymptomatic Cholelithiasis
NMO Journal
cholelithiasis
gallstone
management
title Management of Asymptomatic Cholelithiasis
title_full Management of Asymptomatic Cholelithiasis
title_fullStr Management of Asymptomatic Cholelithiasis
title_full_unstemmed Management of Asymptomatic Cholelithiasis
title_short Management of Asymptomatic Cholelithiasis
title_sort management of asymptomatic cholelithiasis
topic cholelithiasis
gallstone
management
url https://journals.lww.com/10.4103/JNMO.JNMO_10_25
work_keys_str_mv AT chiranjivakhandelwal managementofasymptomaticcholelithiasis
AT utpalanand managementofasymptomaticcholelithiasis
AT kislaykant managementofasymptomaticcholelithiasis