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No evidence to assess surgical treatment in asymptomatic gallstones

Cholecystectomy is currently advised only for symptomatic gallstones. However, about 4% of patients with asymptomatic gallstones develop symptoms including cholecystitis, obstructive jaundice, pancreatitis, and gallbladder cancer. Literature search was performed for evidence from randomised clinical trials to find whether cholecystectomy was indicated in patients with silent (asymptomatic) gallstones. There is no randomised trial comparing cholecystectomy versus no cholecystectomy in silent gallstones. Further evaluation of observational studies, which measure outcomes such as obstructive jaundice, gallstone-associated pancreatitis, and/or gall-bladder cancer for sufficient duration of follow-up is necessary before randomised trials are designed in order to evaluate whether cholecystectomy or no cholecystectomy is better for asymptomatic gallstones.

研究背景

Cholecystectomy is currently advised only for patients with symptomatic gallstones. However, about 4% of patients with asymptomatic gallstones develop symptoms including cholecystitis, obstructive jaundice, pancreatitis, and gallbladder cancer.

研究目的

To assess the benefits and harms of surgical removal of the gallbladder for patients with asymptomatic gallstones.

检索策略

We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until May 2008.

纳入排除标准

Only randomised clinical trials (irrespective of language, blinding, or publication status) comparing cholecystectomy and no cholecystectomy were considered for the review.

资料收集与分析

We were unable to identify any randomised clinical trials comparing cholecystectomy versus no cholecystectomy.

主要结果

We were unable to identify any randomised clinical trial comparing cholecystectomy versus no cholecystectomy.

作者结论

There are no randomised trials comparing cholecystectomy versus no cholecystectomy in patients with silent gallstones. Further evaluation of observational studies, which measure outcomes such as obstructive jaundice, gallstone-associated pancreatitis, and/or gall-bladder cancer for sufficient duration of follow-up is necessary before randomised trials are designed in order to evaluate whether cholecystectomy or no cholecystectomy is better for asymptomatic gallstones.

引用文献
Gurusamy KS, Samraj K. Cholecystectomy for patients with silent gallstones. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD006230. DOI: 10.1002/14651858.CD006230.pub2.

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