если я правильно понимаю, то размер конкремента 3 х2.5 см, как правило конкременты более 3 см даже без симптомов предлагают удалять лапароскопически, потому что при росте до 4-5 см возникают техн. трудности при лапаро-удалении и нужно быть готовым с открытой хирургии
In terms of treatment, most gallstone patients remain asymptomatic and can be managed with watchful waiting [[21], [22], [23]]. Asymptomatic gallstones > 3 cm are at higher risk to develop gallbladder cancer and hence preventive LC is warranted [24,25].
'"Persons with large gallstones were found to be at increased risk for cancer. For those with stone diameters of 2.0 to 2.9 cm, the odds ratio ( v stone size <1 cm) was 2.4; for stones 3 cm or larger, the ratio was 10.1. "
Others reported a gallstone ileus that occurred with a large asymptomatic gallstone, and recommended prophylactic cholecystectomy for large gallstones even if asymptomatic [3]. In addition, fatal abdominal hemorrhage associated with non-traumatic perforation of gallbladder due to large gallstone is another reason for prophylactic cholecystectomy...
Largest case series of giant gallstones ever reported, and review of the literature
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