ASYMPTOMATIC CHOLELITHIASIS: EXPECTANT OR CHOLECYSTECTOMY. A SYSTEMATIC REVIEW

ASYMPTOMATIC CHOLELITHIASIS: EXPECTANT OR CHOLECYSTECTOMY. A SYSTEMATIC REVIEW

Asymptomatic cholelithiasis is a highly prevalent disease, and became more evident after the currently greater access to imaging tests. Therefore, it is increasingly necessary to analyse the risks and benefits of performing a prophylactic cholecystectomy. To seek the best evidence in order to indica...

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Bibliographic Details
Published in:Arquivos brasileiros de cirurgia digestiva : ABCD Vol. 36; p. e1747
Main Authors: Alves, Jose Roberto, Klock, Diurlhane Mainara, Ronzani, Filipe Gonçalves, Santos, Sheyne Luiz Dos, Amico, Enio Campos
Format: Journal Article
Language:English
Published: Brazil Colégio Brasileiro de Cirurgia Digestiva 2023
Subjects:
Cholecystectomy
Cholecystectomy - methods
Cholelithiasis
Gallbladder
Gallstones
Gallstones - surgery
Humans
Review
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Summary:Asymptomatic cholelithiasis is a highly prevalent disease, and became more evident after the currently greater access to imaging tests. Therefore, it is increasingly necessary to analyse the risks and benefits of performing a prophylactic cholecystectomy. To seek the best evidence in order to indicate prophylactic cholecystectomy or conservative treatment (clinical follow-up) in patients with asymptomatic cholelithiasis. A systematic review was performed using the PubMed/Medline database, according to PRISMA protocol guidelines. The review was based on studies published between April 26, 2001 and January 07, 2022, related to individuals older than 18 years., The following terms/operators were used for search standardization: (asymptomatic OR silent) AND (gallstones OR cholelithiasis). We selected 18 studies eligible for inference production after applying the inclusion and exclusion criteria. Also, the Tokyo Guideline (2018) was included for better clarification of some topics less or not addressed in these studies. Most evidence point to the safety and feasibility of conservative treatment (clinical follow-up) of asymptomatic cholelithiasis. However, in post-cardiac transplant patients and those with biliary microlithiasis with low preoperative surgical risk, a prophylactic cholecystectomy is recommended. To establish these recommendations, more studies with better levels of evidence must be conducted.
Bibliography:Conflict of interests: None
ISSN:0102-6720
2317-6326
DOI:10.1590/0102-672020230029e1747