Key priorities for implementation

Key priorities for implementation

The following recommendations have been identified as priorities for implementation. The full list of recommendations is in section 1.

  • Reassure people with asymptomatic gallbladder stones found in a normal gallbladder and normal biliary tree that they do not need treatment unless they develop symptoms.

  • Offer early laparoscopic cholecystectomy (to be carried out within 1¬†week of diagnosis) to people with acute cholecystitis.

  • Reconsider laparoscopic cholecystectomy for people who have had percutaneous cholecystostomy once they are well enough for surgery.

  • Clear the bile duct:

    • surgically at the time of laparoscopic cholecystectomy or

    • with endoscopic retrograde cholangiopancreatography (ERCP) before or at the time of laparoscopic cholecystectomy.

  • If the bile duct cannot be cleared with ERCP, use biliary stenting to achieve biliary drainage only as a temporary measure until definitive endoscopic or surgical clearance.

  • National Institute for Health and Care Excellence (NICE)