A 45-year-old obese woman presents with right upper quadrant colic radiating to the right shoulder after fatty meals. Ultrasound reveals multiple gallstones but a normal common bile duct. The next best step in management is:
- A Laparoscopic cholecystectomy ✓
- B ERCP with sphincterotomy
- C Ursodeoxycholic acid dissolution therapy
- D Percutaneous cholecystostomy
Correct answer: A. Laparoscopic cholecystectomy
Explanation
Symptomatic cholelithiasis (biliary colic) with no common bile duct involvement is best managed by laparoscopic cholecystectomy, which eliminates recurrent biliary colic and prevents complications such as acute cholecystitis, cholangitis, and gallstone pancreatitis. ERCP with sphincterotomy is indicated for common bile duct stones, not gallbladder stones alone. Ursodeoxycholic acid has a very high recurrence rate and is rarely used. Percutaneous cholecystostomy is reserved for critically ill patients unfit for surgery.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.