Clinical management

Laparoscopic surgery no more effective than conservative management for uncomplicated gallstones

A study investigated the effectiveness of conservative management compared with laparoscopic cholecystectomy for management of uncomplicated symptomatic gallstone disease.
434 adults referred to UK secondary care with uncomplicated gallstone disease were randomly assigned to conservative management or laparoscopic cholecystectomy.
At 18 months, pain didn’t significantly differ between both groups.
In the short term (≤18 months), laparoscopic surgery is no more effective than conservative management for adults with uncomplicated symptomatic gallstone disease, hence conservative management should be considered as an alternative to surgery - further research is needed to determine longer-term outcomes.

Discuss this new evidence with patients presenting with symptomatic gallstone disease to help inform referral decisions.
If you’re looking for an idea for your next appraisal PDP, could you review your outpatient referrals to surgical specialties over the past 2 years - are there any learning points/could any referrals have been avoided?

Read more about the research informing this GEM: https://www.bmj.com/content/383/bmj-2023-075383