Biliary Cripple and the Spectrum of Complications following Cholecystectomy: A Case Report

Shrestha, Anish Kumar; Sah, Jayant Kumar; Ghimire, Bikal; Bhandari, Aashna; Shrestha, Anisha

doi:10.1155/2022/5370722

Cited by 1 publication

(1 citation statement)

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“…The incidence of bile duct injury is 0.4%–1.5% in laparoscopy as compared with open surgery with a rate of 0.3% 9,10 . Bile duct injury leads to increased chances of morbidities and an overall decreased quality of life—turning the person into a “biliary cripple.” 11 There is minimal evidence to justify surgery for people with asymptomatic gallstones. In 2018, the Society of American Gastrointestinal and Endoscopic Surgeons issued guidelines recommending “no cholecystectomy” in asymptomatic patients 12 .…”

Section: Introductionmentioning

confidence: 99%

An Indian surgeon's perspective on management of asymptomatic gallstones

Virk,

Arora,

Patil

et al. 2024

Asian J Endoscop Surgery

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IntroductionCholelithiasis is widely prevalent in India, with a majority of patients being asymptomatic while a small proportion experiencing mild complications. In the laparoscopic era, the rate of cholecystectomies has increased owing to early recovery and fewer complications. In asymptomatic patients, the risk of complications must be balanced against the treatment benefit. Recent guidelines suggest no prophylactic cholecystectomy in asymptomatic patients. We aimed to find out the Indian surgeons' perspective on asymptomatic gallstone management.MethodsA cross‐sectional e‐survey was conducted of practicing surgeons, onco‐surgeons and gastrointestinal‐surgeons in India. The survey had questions regarding their perspective on laparoscopic cholecystectomy and treatment modalities in asymptomatic gallstones.ResultsA total of 196 surgeons responded to the survey. Their mean age was 42.3 years. Overall, 111 (57%) respondents worked in the private sector. Most surgeons (164) agreed that the rate of cholecystectomy has increased since the advent of laparoscopy; 137 (70%) respondents agreed that they would not operate on patients without risk factors. Common bile duct stones, chronic hemolytic diseases, transplant recipients, and diabetes mellitus were the risk factors. Majority of the participants agreed on not performing a cholecystectomy in patients with asymptomatic gallstones.ConclusionThere exists a lack of consensus among Indian surgeons on asymptomatic gallstone management in India. Where the majority of cases are asymptomatic and do not require surgery, certain comorbidities can influence the line of treatment in individual patients. Currently, the treatment guidelines for asymptomatic patients need to be established as cholecystectomies may be overperformed due to the fear of development of complications.

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Section: Introductionmentioning

confidence: 99%