When is cholecystectomy indicated in the treatment of gallstones (cholelithiasis)?

Updated: Apr 01, 2019
  • Author: Douglas M Heuman, MD, FACP, FACG, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

Cholecystectomy for asymptomatic gallstones may be indicated in the following patients:

  • Those with large (>2 cm) gallstones

  • Those who have a nonfunctional or calcified (porcelain) gallbladder on imaging studies and are at high risk of gallbladder carcinoma

  • Those with spinal cord injuries or sensory neuropathies affecting the abdomen

  • Those with sickle cell anemia in whom the distinction between painful crisis and cholecystitis may be difficult

Patients with the following risk factors for complications of gallstones may be offered elective cholecystectomy, even if they have asymptomatic gallstones:

  • Cirrhosis

  • Portal hypertension

  • Children

  • Transplant candidates

  • Diabetes with minor symptoms


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