A recent study indicates that many patients with gallstones and abdominal pain do not feel much better after cholecystectomy, which means that surgery may not always be necessary.
Treatment guidelines in many countries recommend cholecystectomy when the patient suffers from abdominal pain associated with the presence of stones. But when there is no emergency, there is no consensus on criteria for doctors to decide who patients can avoid surgery, receive medication, and change lifestyle guidelines.
For the current study, the researchers tested whether patients with gall bladder problems and receiving treatment at outpatient clinics would improve better if surgeons followed stricter criteria for deciding on surgery rather than relying on doctors' judgment.
537 of the patients received traditional medical care, while 530 were subject to surgery, including severe pain, persistent pain for 15 to 30 minutes, back pain, and upper abdominal pain responding to painkillers.
Results of pain relief between the two groups did not differ, as more than 40 percent of patients continued after 12 months.
But the conditions reduced the number of patients in the second group compared to the first group by 75 percent, indicating that surgeons need to re-examine the need for eradication in all cases and in the recommended criteria for surgery, according to the Lancet study.
"Patients should know that there is a high probability that gallbladder removal will not be a solution to all their abdominal pain," said Dr. Philippe de Rover, co-researcher of gastroenterology at Radboud University Hospital in Nijmegen, the Netherlands.
"Advice and participation in decision-making are a good way to minimize unnecessary surgery. Patients have to develop the symptoms they suffer from in the list and their doctors should tell them the symptoms that are likely to disappear after the surgery and the symptoms that are less likely or can not be resolved," he said. Surgery ".