Policy Category:
INNF
Who usually applies for funding?
GP/Cons
Asymptomatic Gallstones
Commissioning
decision
Cholecystectomy for asymptomatic gallstones is considered a
low priority for funding and will only be considered in exceptional
circumstances. Funding approval must be sought from the CCG
via the Individual Funding Request process prior to treatment.
Policy Statement:
Gloucestershire Clinical Commissioning Group will not normally fund cholecystectomy for
asymptomatic gallstones.
Asymptomatic gallstones are gallstones detected incidentally in patient who do not have any
abdominal symptoms or have symptoms that are not thought to be due to gallstones.
Rationale:
Cholecystectomy is the surgical removal of the gall bladder. Prophylactic cholecystectomy
due to the presence of asymptomatic gallstones is not generally indicated.
Plain English Summary:
Surgical removal of the gallbladder is one of the most common operations performed by the
NHS. More than 60,000 gallbladder removals are performed each year. The medical term for
gallbladder removal is cholecystectomy.
The gallbladder is a small, pear-shaped pouch in the upper right part of your abdomen
(tummy). It stores bile, the digestive fluid produced by the liver that helps to break down fatty
foods.
Bile is made from cholesterol, bile salts and waste products. When these substances are out
of balance, small, hard stones called gallstones can form. Gallstones often cause no
symptoms and in many cases remain undetected.
Gallstones may be identified incidentally during investigations for other symptoms. Where
this is the case and the gallstones are not causing any symptoms there is no need for
surgical intervention to remove the gallbladder
Evidence base:
Afdhal N. Approach to the patient with incidental gallstones. UpToDate July 2006. Available
at: http://www.utdol.com/utd/content/topic
Meshikhes A. Asymptomatic Gallstones in the Laparoscopic Era. J.R. College of Surgery,
Edinburg. December 2002 742-748. Available at
www.rcsed.ac.uk/journal/vol47_6/47600004.html
Gurusamy KS, Samraj K. Cholecystectomy for patients with silent gallstones. Cochrane
Database of Systematic Reviews 2007, Issue 1. Art. No.: CD006230. DOI:
1
Policy Category:
INNF
Who usually applies for funding?
GP/Cons
10.1002/14651858.CD006230.pub2.
McAlister V, Davenport E, Renouf E. Cholecystectomy deferral in patients with endoscopic
sphincterotomy. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.:
CD006233. DOI: 10.1002/14651858.CD006233.pub2.
Similarity to other local CCG policies – Bristol, South Gloucestershire, Bath and North East
Somerset. West Midlands.
Link to application form – Individual Funding Request application form
For further information please contact GLCCG.IFR@nhs.net
Date of publication
Policy review date
1st August 2015
June 2017
Consultation
Consultee
Planned Care Programme Board
CCG Governing Body Development Session
GHNHSFT (via General Manager/Head of Contracts)
GP Membership (via CCG Live/What’s New This Week)
Date
31st March 2015 (virtual)
4th June 2015
18/05/2015 – 29/05/2015
06/05/2015 – 05/06/2015
Has the consultation included patient representatives?
No
Policy sign off
Reviewing Body
Effective Clinical Commissioning Policy Group
Integrated Governance and Quality Committee
2
Date of review
14th April 2015
18th June 2015