title: Standard preoperative assessment can improve outcome after cholecystectomy.
abstract: OBJECTIVE
  To assess the outcome of cholecystectomy after standard preoperative handling and selection of patients, focusing on the potential of the operation to eliminate biliary colic.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University Hospital, Norway.
  
  
  METHODS
  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 1996.
  
  
  METHODS
  Unless there was a clear indication for cholecystectomy (frequent attacks of biliary colic/or recent complications of gallstones or both), patients were investigated in a standard way to find out what else was causing the abdominal pain.
  
  
  METHODS
  Residual pain was assessed at a clinical examination three months postoperatively, and clinical condition a median of three years later was assessed by a questionnaire.
  
  
  RESULTS
  465 (58%) patients were operated on primarily, and an additional 29 patients were operated on after further evaluation. Three months after cholecystectomy, 35 (7%) had persistent pain, mostly caused by other specific diseases and relieved after specific treatment. A median 3 years postoperatively, only 21 (4%) reported that they still had abdominal pain.
  
  
  CONCLUSIONS
  Standard selection of patient improved the outcome of cholecystectomy. 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.
authors.affiliation: Department of Gastroenterological Surgery, Ullevål Hospital, University of Oslo, Norway.
authors.forename: O
authors.initials: O
authors.lastname: Mjåland
authors.forename: H E
authors.initials: HE
authors.lastname: Høgevold
authors.forename: T
authors.initials: T
authors.lastname: Buanes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome