Gallstones often cause recurring abdominal pain. In the Netherlands, around 25,000 people undergo gallbladder surgery each year, which remains the standard treatment for symptomatic gallstones. Gallbladder removal is intended to provide long-term relief, but this often falls short: after one year, only two-thirds of patients are pain-free, and after five years this proportion remains the same. There is no difference between standard care and a stricter, criteria-based selection, and selecting patients based on predefined criteria is safe, with no increase in gallstone-related or surgical complications. A new clinical decision model predicts which patients will experience long-term pain relief, based on pain and additional abdominal symptoms. The model can be used in the consultation room to help patients and doctors decide together whether surgery is likely to be beneficial, enabling more tailored care. For the first time, the environmental impact of gallbladder surgery was assessed. Each procedure produces an average of 56 kilograms of CO₂, with 40% from disposable materials. Healthcare, and surgery in particular, contributes a large share of this CO₂ due to material use. This research provides a starting point to make surgical care more sustainable and identifies key hotspots for improvement. Overall, the findings support more careful and sustainable use of gallbladder surgery: more effective for patients and better for the environment.
Daan J. Comes (1994) obtained his Master of Medicine in 2022 at Radboud University. As a PhD candidate at the Department of Surgery, Radboudumc, he was responsible for the five-year follow-up of the SECURE and SUCCESS trials and the initiation of the RELIEF trial, investigating a decision aid combined with lifestyle interventions for patients with upper abdominal pain. Since October 2024, he works as a surgical resident (ANIOS) at Gelderse Vallei Hospital.