The results of the economic evaluation suggest that , on average , the surgery strategy costs £ 1236 more per patient than the conservative management strategy but was , on average , more effective .
An increase in the number of people requiring surgery while treated conservatively corresponded to a reduction in the cost-effectiveness of the conservative strategy .
The results of this assessment indicate that cholecystectomy is still the treatment of choice for many symptomatic people .
However , approximately half of the people in the observation group did not require surgery or suffer complications in the long term indicating that a conservative therapeutic approach may represent a valid alternative to surgery in this group of people .
BACKGROUND Approximately 10 - 15 % of the adult population suffer from gallstone disease , cholelithiasis , with more women than men being affected .
Cholecystectomy is the treatment of choice for people who present with biliary pain or acute cholecystitis and evidence of gallstones .
However , some people do not experience a recurrence after an initial episode of biliary pain or cholecystitis .
As most of the current research focuses on the surgical management of the disease , less attention has been dedicated to the consequences of conservative management .
OBJECTIVES To determine the clinical effectiveness and cost-effectiveness of  cholecystectomy  compared with observation/conservative management in people presenting with uncomplicated symptomatic gallstones ( biliary pain ) or cholecystitis .
Pain and quality of life in patients with symptomatic, non‐complicated gallbladder stones: results of a randomized controlled trial
Background : Cholecystectomy is intended to relieve symptoms of gallstones , but unfortunately some patients will experience postcholecystectomy symptoms , including pain . There is limited information in the literature on gallstone‐related pain and its influence on quality of life . The aim of this study was to examine how pain and quality of life in patients with symptomatic , uncomplicated gallbladder stones were affected by observation of their condition compared with removal of the gallbladder . Methods : One‐hundred and thirty‐seven patients were r and omized to observation ( watchful waiting ; n = 69 ) or cholecystectomy ( n = 68 ) and answered question naires on pain , quality of life ( PGWB index and NHP Part II ) at r and omization and fixed intervals ( 6 , 12 and 60 months ) . All gallstone‐related events ( hospital admission for pain , complications of gallstone disease and cholecystectomy ) and crossover between treatment groups were recorded . Results : Of patients r and omized to observation , 35 of 69 patients ( 51 % ) eventually underwent a cholecystectomy . Significant improvements in quality of life and pain scores were detected regardless of surgical treatment . Patients that subsequently experienced gallstone‐related events had significantly higher pain scores at r and omization than patients that did not experience any subsequent events , and this difference was maintained throughout follow‐up . Conclusions : Unexpectedly , in the majority of patients symptoms did abate without any significant differences between groups in pain and quality of life . Patients that had high intensity and frequency of pain at r and omization had a higher risk of experiencing subsequent events
The results of the economic evaluation suggest that , on average , the surgery strategy costs £ 1236 more per patient than the conservative management strategy but was , on average , more effective .
An increase in the number of people requiring surgery while treated conservatively corresponded to a reduction in the cost-effectiveness of the conservative strategy .
The results of this assessment indicate that cholecystectomy is still the treatment of choice for many symptomatic people .
However , approximately half of the people in the observation group did not require surgery or suffer complications in the long term indicating that a conservative therapeutic approach may represent a valid alternative to surgery in this group of people .
BACKGROUND Approximately 10 - 15 % of the adult population suffer from gallstone disease , cholelithiasis , with more women than men being affected .
Cholecystectomy is the treatment of choice for people who present with biliary pain or acute cholecystitis and evidence of gallstones .
However , some people do not experience a recurrence after an initial episode of biliary pain or cholecystitis .
As most of the current research focuses on the surgical management of the disease , less attention has been dedicated to the consequences of conservative management .
OBJECTIVES To determine the clinical effectiveness and cost-effectiveness of  cholecystectomy  compared with observation/conservative management in people presenting with uncomplicated symptomatic gallstones ( biliary pain ) or cholecystitis .