[Asymptomatic cholelithiasis. When is a cholecystectomy justified?]

Since the introduction of routine abdominal echography, silent gallstone has become a major medical concern. The management of a patient with silent gallstone, is very controversed, and routine cholecystectomy is not always beneficial. Aged and high operative risk patients, should be treated conservatively. Literature review can identify subgroups of patients in whom cholecystectomy is justified: patients with micro or macro-lithiasis, patients in whom oral cholecystography reveals multiple floating stones, dyskinectic, not opacified or calcified gallbladder, and patients receiving general anesthesia for other reasons than gallbladder disease.