Cholecystectomy may be feasible in patients with silent common duct stones

1. In patients with symptomatic gallbladder stones who were found to have asymptomatic concomitant common bile duct stones (CBDS), laparoscopic cholecystectomy without CBDS removal was associated with acceptable short-term outcomes.

Evidence Rating Level: 2 (Good)

CBDS may be found in up to 20% of individuals undergoing laparoscopic cholecystectomy for symptomatic gallstones. However, there is limited evidence regarding the appropriate management for asymptomatic CBDS discovered during such settings. As such, this multicentre, prospective cohort study sought to investigate the feasibility of a “wait and see” strategy in the management of CBDS for patients undergoing laparoscopic cholecystectomy. 60 patients (mean age, 40; 66.7% female) with symptomatic gallstones and asymptomatic CBDS from various hospitals in Egypt were included in the study between February 2023 and July 2023 and followed for up to 6 months. The primary outcome of interest was the occurrence of biliary manifestations within 6 months following laparoscopic cholecystectomy. Among all patients, 2 (3.3%) developed symptomatic CBDS within 6 months after initial laparoscopic cholecystectomy which did not require surgical intervention and resolved with medical management. After 6 months, 16 patients (26.7%) experienced spontaneous passage of CBDS as confirmed by abdominal ultrasound. Overall, this study found that, among patients with symptomatic gallbladder stones requiring laparoscopic cholecystectomy, a “wait and see” strategy for asymptomatic CBDS was associated with acceptable short-term outcomes. 

Click to read the study in BMC Gastroenterology

Image: PD

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