title: Wait-and-see policy versus cholecystectomy after endoscopic sphincterotomy for bile-duct stones in high-risk patients with co-existing gallbladder stones: a prospective randomised trial.
abstract: OBJECTIVE
  Endoscopic sphincterotomy (ES) is one of the most important advances in the treatment of common bile duct (CBD) stones. However, the use of ES to remove CBD stones in high-risk patients without cholecystectomy is still debatable. The aim of this study was to compare the efficacy of a wait-and-see policy versus cholecystectomy after ES for CBD stones in high-risk patients with co-existing cholelithiasis.
  
  
  METHODS
  A total of 162 patients after undergoing ES with the clearance of CBD stones were randomised after informed consent to cholecystectomy or conservative management of their gallbladder stones.
  
  
  RESULTS
  The results indicated that cholecystectomy after ES for CBD stones significantly reduced the biliary complications in high-risk patients.
  
  
  CONCLUSIONS
  Every patient who has both CBD stones and gallstones with significant co-morbid illnesses, after clearance of CBD stones by ES, should undergo early cholecystectomy.
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India.
authors.forename: Showkat A
authors.initials: SA
authors.lastname: Zargar
authors.affiliation: Department of Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India. Electronic address: mozn33@gmail.com.
authors.forename: Mosin
authors.initials: M
authors.lastname: Mushtaq
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India.
authors.forename: Mashkoor A
authors.initials: MA
authors.lastname: Beg
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India.
authors.forename: Gul
authors.initials: G
authors.lastname: Javaid
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India.
authors.forename: Bashir A
authors.initials: BA
authors.lastname: Khan
authors.affiliation: Department of Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India.
authors.forename: Rayhana
authors.initials: R
authors.lastname: Hassan
authors.affiliation: Department of Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India.
authors.forename: Reyaz A
authors.initials: RA
authors.lastname: Kasana
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India.
authors.forename: Sameena
authors.initials: S
authors.lastname: Tabassum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000009:adverse effects; D041761:Cholecystolithiasis / Q000150:complications / Q000628:therapy*; D042883:Choledocholithiasis / Q000150:complications / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D016717:Sphincterotomy, Endoscopic; D057832:Watchful Waiting
keywords: Biliary colic; Cholecystectomy; Common bile duct; Endoscopic sphincterotomy