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About half of patients with an initial episode of gallstone pain develop recurrent biliary colic. Patients with uncomplicated symptomatic gallstones often are advised to undergo laparoscopic cholecystectomy, but among those who do, as many as 40% report continued pain and abdominal symptoms. Does surgery provide better overall symptom relief than conservative management?
Researchers in the U.K. recruited 400 patients with uncomplicated symptomatic gallstone disease (i.e., biliary colic or uncomplicated acute cholecystitis) and randomized them to cholecystectomy or conservative management (i.e., observation, analgesics, and dietary advice). Eighteen months after randomization, 67% of patients assigned to cholecystectomy and 25% of patients as…