Cholecystectomy for uncomplicated gallbladder stones does not follow evidence-based recommendations

INTRODUCTION: The introduction of laparoscopic cholecystectomy was followed by a steep increase in the cholecystectomy rate, which has remained on an unchanged, high level. The main indication for cholecystectomy in Denmark in cases with uncomplicated gallbladder stones is socially debilitating pain. The objective of the present study was to investigate whether the indication “socially debilitating pain” was reported in the patien’s file when he or she was referred to surgery. METHODS: Hospital files for all patients referred to surgical evaluation for uncomplicated gallbladder stones from Odense University Hospital’s service area (approximately 449,000 inhabitants) within a one-year period (2014) were reviewed. RESULTS: Among 1,003 eligible patients, a total of 516 met the inclusion criteria, 407 (78.9%) of whom underwent elective cholecystectomy. For only 89 (21.9%) of these 407 patients, the indication of socially debilitating pain was described in the patient files. CONCLUSIONS: Our results may represent overtreatment and/or incorrect selection of patients suitable for surgery. More and larger prospective cohort studies are warranted to elucidate the indications for cholecystectomy in uncomplicated gallbladder stones.