Abstract Background There is a lack of consensus in selecting patients who do or do not benefit from surgery when patients present with abdominal pain and gallbladder stones are present. This review aimed to give an overview of results from recent trials and available literature to improve treatment decisions in patients with uncomplicated cholecystolithiasis. Methods First, an overview of different symptom criteria for laparoscopic cholecystectomy in patients with uncomplicated cholecystolithiasis is given, based on national and international guidelines. Second, treatment outcomes (absence of biliary colic, pain-free state, biliary and surgical complications) are summarized, with data from three clinical trials. Finally, personal advice for treatment decisions in patients with uncomplicated cholecystolithiasis is provided, based on recent trials, the available literature, and expert opinion. Results This review describes different guidelines and criteria sets for uncomplicated cholecystolithiasis, provides an overview of outcomes after cholecystectomy, and advises on treatment decisions in patients with abdominal pain and gallbladder stones. After cholecystectomy, biliary colic is resolved in 95 per cent of patients. However, non-specific abdominal pain persists in 40 per cent. Irritable bowel syndrome and functional dyspepsia significantly increase the risk of persistent pain. Age, previous abdominal surgery, baseline pain score on a visual analogue scale, pain characteristics, nausea, and heartburn are part of the SUCCESS criteria, and are associated with clinically relevant pain reduction after gallbladder removal. Conclusion The surgical community can now give more personalized advice on surgery to improve care for patients with abdominal pain and uncomplicated cholecystolithiasis.

中文翻译：

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有症状胆结石疾病的定制诊断和治疗

摘要 背景当患者出现腹痛和胆囊结石时，对于选择是否从手术中受益的患者缺乏共识。本综述旨在概述最近的试验结果和现有文献，以改善无并发症胆囊结石患者的治疗决策。 方法首先，根据国家和国际指南，概述了无并发症胆囊结石患者腹腔镜胆囊切除术的不同症状标准。其次，根据三项临床试验的数据总结治疗结果（无胆绞痛、无痛状态、胆道和手术并发症）。最后，根据最近的试验、现有文献和专家意见，为无并发症的胆囊结石患者的治疗决策提供个人建议。 结果这篇综述描述了针对单纯性胆囊结石的不同指南和标准，概述了胆囊切除术后的结果，并就腹痛和胆囊结石患者的治疗决策提出了建议。胆囊切除术后，95% 的患者胆绞痛得到缓解。然而，40% 的人仍然存在非特异性腹痛。肠易激综合征和功能性消化不良会显着增加持续性疼痛的风险。年龄、既往腹部手术史、视觉模拟评分的基线疼痛评分、疼痛特征、恶心和胃灼热是成功标准的一部分，并且与胆囊切除后临床相关疼痛减轻相关。 结论外科界现在可以提供更个性化的手术建议，以改善对腹痛和无并发症胆囊结石患者的护理。