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. 2022 Dec 12;11(1):267.
doi: 10.1186/s13643-022-02135-8.

Management of symptomatic cholelithiasis: a systematic review

Rivfka Shenoy  1   2   3 , Patrick Kirkland  4 , Joseph E Hadaya  5 , M Wynn Tranfield  6 , Michael DeVirgilio  5   7 , Marcia M Russell  5   7 , Melinda Maggard-Gibbons  5   7   8   9
Affiliations

Management of symptomatic cholelithiasis: a systematic review

Rivfka Shenoy et al. Syst Rev. .

Abstract

Background: Symptomatic cholelithiasis is a common surgical disease and accounts for half of the over one million cholecystectomies performed in the USA annually. Despite its prevalence, only one prior systematic review has examined the evidence around treatment strategies and it contained a narrow scope. The goal of this systematic review was to analyze the clinical effectiveness of treatment options for symptomatic cholelithiasis, including surgery, non-surgical therapies, and ED pain management strategies.

Methods: Literature search was performed from January 2000 through June 2020, and a narrative analysis was performed as studies were heterogeneous.

Results: We identified 12 publications reporting on 10 trials (9 randomized controlled trials and 1 observational study) comparing treatment methods. The studies assessed surgery, observation, lithotripsy, ursodeoxycholic acid, electro-acupuncture, and pain-management strategies in the emergency department. Only one compared surgery to observation.

Conclusion: This work presents the existing data and underscores the current gap in knowledge regarding treatment for patients with symptomatic cholelithiasis. We use these results to suggest how future trials may guide comparisons between the timing of surgery and watchful waiting to create a set of standardized guidelines. Providing appropriate and timely treatment for symptomatic cholelithiasis is important to streamline care for a costly and prevalent disease.

Trial registration: PROSPERO Protocol Number: CRD42020153153.

Keywords: Symptomatic cholelithiasis; UDCA; biliary colic; cholecystectomy; management; treatment.

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Conflict of interest statement

Dr. Rivfka Shenoy was supported by the VA Office of Academic Affiliations through the VA/National Clinician Scholars Program while working on this study. The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Literature flow. *PubMed = 2575, Cochrane Trials 909, Cochrane Review 25, Embase 2838
See this image and copyright information in PMC

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