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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.


WiseGP Action Points

  • 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:

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