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Need for Prophylactic Cholecystectomy in Silent Gall Stones in North India


One of the criteria for recommending cholecystectomy for silent gall stones, is gall stones in regions with high incidence of gall bladder cancer. Both gall stones and gall bladder cancer are common in North India. All tertiary care centres in India report high rates of gall bladder cancer (GBC) incidence and poor treatment outcomes in the majority of cases due to advanced stage of presentation. Csendes of Chile has reported very high incidence of gallbladder cancer in Chile and Bolivia and advocated prophylactic cholecystectomy in asymptomatic patients. Incidence rate of gall bladder cancer in Indian males is equal to that of Chile, whereas in females, the rates are almost double the rates of Chile. Indians have also been found to have high concentrations of heavy metals in gall bladder wall, and antibodies to tumor suppressor genes. In India, gall bladder cancer is the commonest GI cancer in women and fourth commonest cancer overall in the female population. In view of the epidemiology and clinical scenario of gall bladder cancer and proven safety of laparoscopic cholecystectomy, there is a need to act before it is too late in the current rates of gall bladder cancer. This study looks at the evidence correlating gall stones and gall bladder cancer, in relation to India. There is pressing evidence today to justify a strategy of prophylactic cholecystectomy in silent gall stones in North India. Data for this study was selected through an internet based search for literature concerning gall stones and gall bladder cancer in India, and for prophylactic cholecystectomy.

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  1. 1.

    Gupta SK, Shukla VK (2004) Silent gallstones: a therapeutic dilemma. Trop Gastroenterol 25(2):65–8

    CAS  PubMed  Google Scholar 

  2. 2.

    Patiño JF (1996) Suitability of laparoscopic cholecystectomy in the asymptomatic cholelithiasis patient. Acta Gastroenterol Latinoam 26(3):187–92

    PubMed  Google Scholar 

  3. 3.

    Kapoor VK, McMichael AJ (2003) Gallbladder cancer: an ‘Indian’ disease. Natl Med J India 16(4):209–13

    CAS  PubMed  Google Scholar 

  4. 4.

    Behari A, Kapoor VK (2010) Does gallbladder cancer divide India? Indian J Gastroenterol 29(1):9–13

    Article  Google Scholar 

  5. 5.

    Murthy N, Rajaram D, Gautham MS, Shivraj NS, Pruthvish S, George PS et al (2011) Trends in incidence of gall bladder cancer – Indian scenario. Gastrointest Cancer: Targets Ther 1:1–9

    Google Scholar 

  6. 6.

    Mohandas KM, Patil PS (2006) Cholecystectomy for asymptomatic gallstones can reduce gall bladder cancer mortality in northern Indian women. Indian J Gastroenterol;25 (3)

  7. 7.

    Chhabra D, Oda K, Jagannath P, Utsunomiya H, Takekoshi S, Nimura Y (2012) Chronic heavy metal exposure and gallbladder cancer risk in India, a comparative study with Japan. Asian Pac J Cancer Prev 13(1):187–90

    Article  PubMed  Google Scholar 

  8. 8.

    Nigam P, Misra U, Negi TS, Mittal B, Choudhuri G (2010) Alterations of p53 gene in gallbladder cancer patients of North India. Trop Gastroenterol 31(2):96–100

    PubMed  Google Scholar 

  9. 9.

    Lazcano-Ponce E, Miquel J, Muñoz N, Herrero R, Ferrecio C, Wistuba et al (2001) Epidemiology and molecular pathology of gallbladder cancer. CA: Cancer J Clin 51(6):349–364

    CAS  Google Scholar 

  10. 10.

    Batra Y, Pal S, Dutta U, Desai P, Garg PK, Makharia G et al (2005) Gallbladder cancer in India: a dismal picture. J Gastroenterol Hepatol 20:309–314

    Article  PubMed  Google Scholar 

  11. 11.

    Behari A, Kapoor VK (2012) Asymptomatic Gallstones (AsGS)–To Treat or Not to? Indian J Surg 74(1):4–12

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Kapoor V (2006) Cholecystectomy in patients with asymptomatic gallstones to prevent gall bladder cancer–the case against. Indian J Gastroenterol 25(3):152–154

    CAS  PubMed  Google Scholar 

  13. 13.

    Sakorafas G, Milingos D, Peros G (2007) Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci 52(5):1313–1325

    Article  PubMed  Google Scholar 

  14. 14.

    Lowenfels AB (1985) Gallstones and risk of gallbladder cancer. J Natl Cancer Inst 75(1):77–80

    CAS  PubMed  Google Scholar 

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Correspondence to Alok Vardhan Mathur.

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Key Messages

In view of the high incidence and poor treatment outcomes, of gall bladder cancer, there is pressing evidence today to justify a strategy of prophylactic cholecystectomy for silent gall stones in India. It is disturbing, that in spite of having nearly the highest rates of incidence of gall bladder cancer in the entire world, very little is being discussed about it in Indian literature. Over the long term this will help to reduce the chance of disease progression from silent gall stones to advanced gall bladder cancer.

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Mathur, A.V. Need for Prophylactic Cholecystectomy in Silent Gall Stones in North India. Indian J Surg Oncol 6, 251–255 (2015).

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  • Gall bladder stones
  • Gall bladder cancer
  • India
  • Prophylactic cholecystectomy