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Title: Cholecystectomy for asymptomatic gallstones: Markov decision tree analysis
Authors: Lee, Brian Juin Hsien
Yap, Qai Ven
Low, Jee Keem
Chan, Yiong Huak
Shelat, Vishal G.
Keywords: Science::Medicine
Issue Date: 2022
Source: Lee, B. J. H., Yap, Q. V., Low, J. K., Chan, Y. H. & Shelat, V. G. (2022). Cholecystectomy for asymptomatic gallstones: Markov decision tree analysis. World Journal of Clinical Cases, 10(29), 10399-10412.
Journal: World journal of clinical cases 
Abstract: 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.
ISSN: 2307-8960
DOI: 10.12998/wjcc.v10.i29.10399
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Rights: © The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BYNC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See:
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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