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. 2021 Jan 13:62:150-153.
doi: 10.1016/j.amsu.2020.12.048. eCollection 2021 Feb.

Best evidence topic: Should patients with asymptomatic choledocholithiasis be treated differently from those with symptomatic or complicated disease?

Hossam Nawara  1 , Rashid Ibrahim  1 , Sabry Abounozha  2 , Awad Alawad  3
Affiliations

Best evidence topic: Should patients with asymptomatic choledocholithiasis be treated differently from those with symptomatic or complicated disease?

Hossam Nawara et al. Ann Med Surg (Lond). .

Abstract

Choledocholithiasis is a common finding in clinical practice, with presentation varying from asymptomatic to life-threatening complications. In symptomatic patients, there is no doubt that treatment to clear the bile duct is indicated, but there is still a debate regarding the treatment of patients with silent common bile duct stones (CBDS). The question addressed by this best evidence topic is whether patients with asymptomatic CBDS should be managed in the same way as patients with symptoms or complications. The search strategy yielded 609 articles, from which 8 articles found to be relevant to this topic. We also summarised the most notable societal guidelines recommendations, regarding this topic. We tabulated the article title, author, year, country, study type, outcomes, results, and comments. We concluded that patients with asymptomatic CBD stones should be offered endoscopic treatment If they are fit, after discussion of the potential risks and benefits of both options of conservative and interventional treatment with the patients.

Keywords: Asymptomatic; Bile duct stones; CBD stones; Choledocholithiasis; ERCP.

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