Patient decision-making in symptomatic gallbladder disease.

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Patient Decision-Making

Background:

• Symptomatic gallstones affect millions, yet few undergo cholecystectomy.
• Factors influencing patient choices for medical management of gallbladder disease are poorly understood.
• Understanding patient decision-making is crucial for optimizing gallbladder disease care.

Purpose of the Study:

• Assess patient decision-making regarding cholecystectomy.
• Evaluate experiences with medical management for gallbladder disease.
• Gauge interest in a clinical trial comparing surgical versus medical treatment.

Main Methods:

• Cross-sectional survey conducted via Amazon's MTurk platform (January-May 2020).
• 148 eligible participants without prior cholecystectomy completed the survey.
• Data collected on symptom management, treatment choices, and clinical trial willingness.

Main Results:

• 60% of participants were recommended surgery, but only 43% planned to undergo it.
• Common reasons for avoiding surgery included surgical risks and preference for ongoing medical management.
• 36% used medications/supplements (e.g., ursodeoxycholic acid) and 85% attempted lifestyle changes.
• 67% expressed willingness to join a comparative clinical trial.

Conclusions:

• A substantial number of patients with symptomatic gallbladder disease opt against cholecystectomy.
• Alternative therapies are frequently used despite limited evidence.
• Patient interest and the lack of comparative data support the need for a clinical trial comparing cholecystectomy and medical management.