Send to

Choose Destination
J Gastrointest Surg. 2010 Aug;14(8):1271-9. doi: 10.1007/s11605-010-1219-6. Epub 2010 May 26.

Risk assessment in cholelithiasis: is cholecystectomy always to be preferred?

Author information

CoRPS-Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, 5000 LE, Tilburg, the Netherlands.



As many patients with gallstone disease do not benefit from cholecystectomy, preoperative recognition of such high-risk patients is important. The aim of the study is to identify predictors of persisting symptoms at 6 months after cholecystectomy for patients with different preoperative symptomatology.


Participants in this prospective study were consecutive patients (n = 172), age 18-65 years, with symptomatic cholelithiasis, undergoing a laparoscopic cholecystectomy. Predictors were identified using uni- and multivariate regression analyses.


At 6 months postcholecystectomy, patients with only preoperative biliary symptoms were most often free of symptoms (62.5%). Patients with only dyspeptic symptoms most often reported persistence of preexisting symptoms (63.2%). Preoperative non-specific symptoms predicted the report of postoperative biliary and/or dyspeptic symptoms (OR = 4.5-6.1). Persistence of preexisting pattern of symptoms was predicted by the use of psychotropic medication (OR = 5.3) and dyspeptic symptoms (OR = 4.5). Postoperative biliary symptoms were predicted by High Trait Anxiety (HTA) (OR = 10.6).


Surgeons should take account of individual risks of patients in the management of cholelithiasis. Instead of cholecystectomy, expectative management should be the first choice in patients with non-specific symptoms, with dyspeptic symptoms only, with HTA and in patients using psychotropic medication.

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center