gallstones: cholcystectomy often not relieve pain
A recent study of patients with abdominal pain and gallstones found that a more restrictive strategy for cholecystectomy was noninferior to usual care, that fewer cholecystectom ies were done, but notably in both groups almost 40% had continued abdominal pain one year later (see cholecystectomy residual pain lancet2019 in dropbox, or doi.org/10.1016/S0140-6736(19)30941-9) Details: -- multicenter randomized noninferiority study in 24 academic and nonacademic hospitals in the Netherlands, between 2014-2017 -- 1067 patients aged 18 to 95 who had abdominal pain and ultrasound-proven gallstones or sludge -- mean age 49, 73% female, BMI 28, ASA classification 2 (from American Society of Anesteriologists: mild systemic disease), history of abdominal surgery 38%, use of pain meds 48% (32% NSAIDs, 11% acetaminophen), current smoker 20%, current drinker 47%, baseline VAS (Visual Analog Scale) pain score 7.5/baseline Gastrointestinal Quality...