A 45-year-old female has a solitary gall stone 1.5 cm in size which was incidentally diagnosed by ultrasound. She has no symptom. What should be the best line of management?
|A||Cholecystectomy only, if she develops biliary colic|
|B||Lap cholecystectomy immediately|
|C||Lap cholecystectomy even if she is asymptomatic after 2 months|
|D||Open cholecystectomy even if she is asymptomatic after 2 months|
a. Most patients will remain asymptomatic from their gallstones throughout life.
b. Symptomatic gallstone disease may progress to complications related to the gallstones. These include acute cholecystitis, choledocholithiasis with or without cholangitis, gallstone pancreatitis, cholecystocholedochal fistula, cholecystoduodenal fistula, cholecystoenteric fistula leading to gallstone ileus, and gallbladder carcinoma. Rarely, complication of gallstones is the presenting picture.
c. Gallstones in patients without biliary symptoms are commonly diagnosed incidentally on ultrasonography, CT scans, abdominal radiography, or at laparotomy
d. Approximately 3% of asymptomatic individuals become symptomatic per year (i.e., develop biliary colic). Once symptomatic, patients tend to have recurring bouts of biliary colic.
e. Porcelain gallbladder, a rare premalignant condition in which the wall of the gallbladder becomes calcified, is an absolute indication for cholecystectomy.