Cholecystectomy for asymptomatic gallstones:Markov decision tree analysis  

作　　者：Brian Juin Hsien Lee Qai Ven Yap Jee Keem Low Yiong Huak Chan Vishal G Shelat 

机构地区：[1]Lee Kong Chian School of Medicine,Nanyang Technological University,Singapore S308232,Singapore [2]Biostatistics Unit,Yong Loo Lin School of Medicine,National University of Singapore,Singapore S117597,Singapore [3]Department of General Surgery,Tan Tock Seng Hospital,Singapore S308433,Singapore

出　　处：《World Journal of Clinical Cases》2022年第29期10399-10412,共14页世界临床病例杂志

摘　　要：Gallstones are a common public health problem,especially in developed countries.There are an increasing number of patients who are diagnosed with gallstones due to increasing awareness and liberal use of imaging,with 22.6%-80% of gallstone patients being asymptomatic at the time of diagnosis.Despite being asymptomatic,this group of patients are still at life-long risk of developing symptoms and complications such as acute cholangitis and acute biliary pancreatitis.Hence,while early prophylactic cholecystectomy may have some benefits in selected groups of patients,the current standard practice is to recommend cholecystectomy only after symptoms or complications occur.After reviewing the current evidence about the natural course of asymptomatic gallstones,complications of cholecystectomy,quality of life outcomes,and economic outcomes,we recommend that the option of cholecystectomy should be discussed with all asymptomatic gallstone patients.Disclosure of material information is essential for patients to make an informed choice for prophylactic cholecystectomy.It is for the patient to decide on watchful waiting or prophylactic cholecystectomy,and not for the medical community to make a blanket policy of watchful waiting for asymptomatic gallstone patients.For patients with high-risk profiles,it is clinically justifiable to advocate cholecystectomy to minimize the likelihood of morbidity due to complications.

关 键 词：ASYMPTOMATIC CHOLECYSTECTOMY CHOLELITHIASIS GALLBLADDER GALLSTONE 

分 类 号：R657.4[医药卫生—外科学]