Cracking the silent gallstone code: Wait or operate?

Core Tip

Core Tip: The discussion surrounding silent gallstones remains unresolved. Despite only approximately 20% of gallstones becoming symptomatic, the widespread use of abdominal ultrasounds, coupled with the availability of laparoscopic cholecystectomies and their quick recovery times, promotes the preemptive removal of asymptomatic gallstones. Patients often opt for surgery to avert future complications, including gallbladder cancer in certain areas. The likelihood of asymptomatic gallstones progressing to symptomatic disease is very low, and complications typically do not arise without symptoms. Given this and the absence of clear guidelines, there is a need for risk stratification to selectively manage those in high-risk groups with silent gallstones.