Best evidence topic: Does the presence of a large gallstone carry a higher risk of gallbladder cancer?

Abstract A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In a patient with symptomatic gallstone disease does the presence of a large sized gallstone associated with a higher risk of gallbladder cancer? Using the reported search, 3876 papers were found. 6 studies were deemed to be suitable to answer the question. The outcome assessed was the relationship between the presence of large sized gallstones and the risk of gallbladder cancer. It appears from the current available evidence that there is a strong association of a large sized gallstones and gallbladder cancer. Larger stones (>3 cm) have the greatest risk to develop gallbladder cancer, especially in symptomatic gallstone disease patients. Authors recommend special care for this patient's group and to warrant cholecystectomy when the clinical condition allows.