Does Everyone with Biliary Colic Need a Cholecystectomy?

Biliary colic secondary to cholelithiasis is among the most common reasons for surgical referral and consultation. However, decision making regarding which patients should undergo laparoscopic cholecystectomy remains nonstandardized, and many patients have persistent symptoms following surgery, sometimes referred to as post-cholecystectomy syndrome.

To identify patients who would most likely benefit from cholecystectomy, investigators in the Netherlands conducted a multicenter, randomized, noninferiority study that compared outcomes in 1067 participants who were selected for surgery either at the surgeon's discretion (standard-care group) or according to more-stringent criteria (restrictive-strategy group). Patients in the restrictive-strate…