Therapy of gallstone disease: What it was, what it is, what it will be

Table 3 Indications for “prophylactic” cholecystectomy (i.e., asymptomatic gallstone patients bearing a high risk of becoming symptomatic)

Children (because they are exposed to the long-term physical presence of stones[58])

Morbid obese patients undergoing bariatric surgery (high risk to become symptomatic during rapid weight loss[62])

Increased risk for gallbladder cancer[63]

Patients with large gallstones (greater than 3 cm)[64,65]

A “porcelain” gallbladder[66] or gallbladder polyps rapidly growing or larger than 1 cm

Native Americans with gallstones (risk of gallbladder cancer 3 to 5 percent)[67]

Gallstone patients with sickle cell anemia (formation of calcium bilirubinate gallstones due to chronic hemolysis. Patients may become symptomatic with recurrent episodes of abdominal pain[68])

Coexistence of small gallstones and gallbladder dysmotility (increased risk of pancreatitis[47])

Adapted from[25,63,148] with permission.