Comes DJ, Wennmacker SZ, Latenstein CSS, van der Bilt J, Buyne O, Donkervoort SC et al.
JAMA Surg 2024; 159: 1235-1243.
A restrictive policy for cholecystectomy involved stepwise selection criteria for the surgery based on symptoms and signs. This study evaluated 5-year outcomes. In 1607 patients studied, 387/529 restrictive patients had surgery, compared to 437/536 who had standard care. The chance of being pain-free after five years was similar in both restrictive and standard groups: 61.2 versus 62.8 per cent, respectively, P=0.18.
Comment: Ten percent fewer cholecystectomies in the restrictive group, but the authors note only two thirds of patients were pain-free.
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