Many such patients opt for gallbladder removal, expecting it to cure the pain that strikes when gallstones intermittently obstruct the ducts that secrete bile to aid digestion. A 2019 Dutch study, however, found that up to 40% of patients with so-called uncomplicated gallstone disease still had abdominal pain one year after gallbladder removal.
"Until now, we did not know which patient with which symptoms would benefit most from this operation," said Dr. Philip de Reuver of Radboud University Medical Center in The Netherlands.
As reported in JAMA Surgery, his team used data on 1,561 patients with painful gallstones, but without complications, to identify factors that predict significant pain reduction after gallbladder removal.
Those factors include older age, no previous abdominal surgery, greater pain at the start, pain that radiates to the back, pain that responds to simple analgesics, nausea, and no heartburn, the researchers found.
An editorial published with the study says the "SUCCESS tool" - available online at https://bit.ly/38cgaQi - can minimize "the chance of performing a procedure with little benefit."
SOURCE: https://bit.ly/3AzNP2K and https://bit.ly/3jOcHwF JAMA Surgery, online August 11, 2021.
By Nancy Lapid
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