First treatment in asymptomatic gall bladder stone?
ANSWER: (D) Wait and watchREF: Schwartz pretest 7th ed p-204, CSDT 11th ed p-546, Bailey & Love 25th ed page 1121"Because fewpatients develop complications without previous biliary symptoms, prophylactic cholecystectomy in asymptomatic persons with gallstones is rarely indicated'Surgical treatment for asymptomatic gall stonesPrerequisites of medical therapy for gall stones* Diabetes* Radiolucent stones* Patients due to undergo bariatricsurgery for morbid obesity* Size<10mm* Functioning GB* Congenital hemolytic anemia* Non acute symptoms* Increased risk of complications1. Immunosuppressed2. Post-transplant* Increased risk of gall bladder cancer1. Large stone > 3cm2. Polyps of Gall bladder, especially if >10 mm3. Porcelain gallbladder(Calcified gall bladder wall)
Immediate surgery
Oral dissolution agents
Endoscopic sphincter ablation
Wait and watch
Gallstone Disease