Objective: To assess the outcome of cholecystectomy after standard preopera
tive handling and selection of patients, focusing on the potential of the o
peration to eliminate biliary colic.
Design: Prospective study.
Setting: University Hospital, Norway.
Patients: 806 patients (median age 56, range 18-91 years, male:female ratio
1:2.7), were referred to our clinic for cholecystectomy between 1992 and 1
996.
Interventions: Unless there was a clear indication for cholecystectomy (fre
quent attacks of biliary colic/or recent complications of gallstones or bot
h), patients were investigated in a standard way to find out what else was
causing the abdominal pain.
Main outcome measures: Residual pain was assessed at a clinical examination
three months postoperatively, and clinical condition a median of three yea
rs later was assessed by a questionnaire.
Results: 465 (58%) patients were operated on primarily, and an additional 2
9 patients were operated on after further evaluation. Three months after ch
olecystectomy, 35 (7%) had persistent pain, mostly caused by other specific
diseases and relieved after specific treatment. A median 3 years postopera
tively, only 21 (4%) reported that they still had abdominal pain.
Conclusion: Standard selection of patient improved the outcome of cholecyst
ectomy. Compared with a historical control group, residual pain after three
months was reduced from 20% to 7%. After three years, 96% of the patients
no longer had their main clinical problem.