What are the indications for cholecystectomy in patients with symptomatic gallstones?

Indications for cholecystectomy in patients presenting with symptomatic gallstones include:

• Diagnosis of symptomatic gallbladder stones, where laparoscopic cholecystectomy is offered as the treatment of choice ¹.
• Acute cholecystitis, where early laparoscopic cholecystectomy should be performed within 1 week of diagnosis ¹,³.
• Symptomatic common bile duct stones, where bile duct clearance and laparoscopic cholecystectomy are recommended ¹.
• Gallbladder empyema when surgery is contraindicated initially and conservative management fails, percutaneous cholecystostomy is used, with reconsideration of cholecystectomy once the patient is stable ¹.

Patients with asymptomatic gallstones generally do not require cholecystectomy unless there are specific risk factors such as a porcelain gallbladder, but this is an exception rather than the rule ².