Gallstones Management (NICE Guidance)

Question 1

What investigations should you offer to someone with suspected gallstone disease?

Answer 1

LFTs

Ultrasound

Question 2

When should you consider MRCP in gallstone disease?

Answer 2

If US didn’t find stones but did find dilated bile duct AND/OR
LFTs are abnormal

Question 3

What is the treatment for people with symptomatic gallstone disease (not acute cholecystitis)?

Answer 3

Elective laparoscopic cholecystectomy

Question 4

What is the treatment for acute cholecystitis?

Answer 4

Laparoscopic cholecystectomy within 1 week of diagnosis

Question 5

What should be offered to people with asymptomatic or symptomatic common bile duct stones, and how should this be carried out?

Answer 5

Bile duct clearance and laparoscopic cholecystectomy

Bile duct should be cleared surgically or with an ERCP before surgery

Question 6

When should biliary stenting be done and is this definitive management?

Answer 6

If the bile duct cannot be cleared with ERCP

Only temporary while awaiting definitive endoscopic or surgical clearance