Persistent Pain Following Cholecystectomy for Patients with Abdominal Pain and Gallstones

Many patients who undergo cholecystectomy for biliary colic (excluding those with cholecystitis, choledocholithiasis, or biliary pancreatitis) have persistent pain following surgery. In a previously published randomized trial, Dutch investigators compared outcomes at 1 year for patients with abdominal pain and gallstones who underwent cholecystectomy at the discretion of their surgeons (with no specific additional selection criteria) versus patients who were managed with more-restrictive surgical indications (NEJM JW Gen Med Jun 15 2019 and Lancet 2019; 393:2322). The restrictive criteria for laparoscopic cholecystectomy included severe pain attacks lasting ≥30 minutes and pain located in the epigastrium or right upper quadrant or radiating…