{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:30:47Z","timestamp":1768433447881,"version":"3.49.0"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T00:00:00Z","timestamp":1591660800000},"content-version":"vor","delay-in-days":160,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Gallstones are present in 10\u201315% of North Americans, but only 20% become symptomatic. This case report describes a patient with a 7.5 cm gallstone detected incidentally while being investigated for cardiac pathology. This is the first report in the English literature of a stone this size that has remained clinically asymptomatic. This work is reported in line with the SCARE criteria.<\/jats:p>\n <\/jats:sec>\n \n Case report<\/jats:title>\n The patient was a 71-year-old Indigenous Canadian male, with atrial fibrillation. His cardiologist ordered a CT scan of his chest, which incidentally identified a large gallstone. He was referred to surgery for asymptomatic cholelithiasis. An uncomplicated laparoscopic cholecystectomy was performed. Final pathology showed a 7.5 cm gallstone with features of chronic cholecystitis.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n The patient\u2019s ethnicity and gallstone size placed him at increased risk for gallbladder cancer, gallstone fistulization and perforation. We reviewed the literature for asymptomatic patients who may benefit from cholecystectomy: transplant recipients and those with hemolytic disorders. Laparoscopic cholecystectomy is not currently indicated in diabetics and bariatric surgery patients.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This case report shows that there are asymptomatic patients with massive gallstones. A review of their history, risk factors for malignancy and future gallstone related complications must be carefully weighed and discussed prior to deciding on surgical versus expectant management.<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.06.028","type":"journal-article","created":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T13:13:50Z","timestamp":1591881230000},"page":"429-432","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Massive gallstone in an asymptomatic Indigenous Canadian male"],"prefix":"10.1097","volume":"72","author":[{"given":"Angela W.","family":"Chan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rathi M.","family":"Sabaratnam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yagan","family":"Pillay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-95-20260114","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.gtc.2010.02.003","article-title":"Epidemiology of gallstones","volume":"39","author":"Stinton","year":"2010","journal-title":"Gastroenterol. Clin. North Am"},{"key":"R2-95-20260114","first-page":"1","article-title":"Wandering gallstones (gallbladder fistulae)","volume":"01\/20","author":"Pillay","year":"2016","journal-title":"Austin Surg. Case Rep"},{"key":"R3-95-20260114","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1002\/jso.20529","article-title":"Contribution of silent gallstones in gallbladder cancer","volume":"93","author":"Tewari","year":"2006","journal-title":"J. Surg. Oncol"},{"key":"R4-95-20260114","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ijsu.2018.10.028","article-title":"The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines","volume":"60","author":"Agha","year":"2018","journal-title":"Int. J. Surg"},{"key":"R5-95-20260114","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ijscr.2011.07.005","article-title":"Giant gallstone: a case report","volume":"2","author":"Becerra","year":"2011","journal-title":"Int. J. Surg. 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Public Health"},{"key":"R9-95-20260114","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1007\/s12262-011-0376-5","article-title":"Asymptomatic gallstones (AsGS) - to treat or not to?","volume":"74","author":"Behari","year":"2012","journal-title":"Indian J. Surg"},{"key":"R10-95-20260114","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1007\/s10620-006-9107-3","article-title":"Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy","volume":"52","author":"Sakorafas","year":"2007","journal-title":"Dig. Dis. 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