Indications for Gallbladder Surgery in Gallstone Disease

NCT ID: NCT01190280

Last Updated: 2010-08-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

1991-10-31

Study Completion Date

2010-08-31

Brief Summary

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The aim of the study is to identify patients with gallstone disease that should be operated and those that may potentially be observed. This selection was based on symptoms and clinical presentation. The consequences that may arise for the patient if observation is chosen compared with outcome after cholecystectomy has been markers of outcome.

Detailed Description

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1. Randomized clinical trial (RCT) of observation versus surgery for uncomplicated gallstone disease
2. RCT of observation versus operation for acute cholecystitis
3. Study of outcome after cholecystectomy in patients from 1. and 2.
4. Study of symptoms in gallstone disease and symptom relief after cholecystectomy
5. Long-term morbidity and mortality, including cancer, after cholecystectomy
6. Long-term follow-up of patients with silent gallstones

Conditions

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Gallstones

Study Groups

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AC - operation

Patients admitted with acute cholecystitis randomized to operation

Cholecystectomy operation

Intervention Type PROCEDURE

Cholecystectomy after randomization

AC - observation

Patients admitted with acute cholecystitis randomized to observation

No interventions assigned to this group

SGBS - operation

Patients admitted with uncomplicated gallstone disease randomized to operation

Cholecystectomy operation

Intervention Type PROCEDURE

Cholecystectomy after randomization

SGBS - observation

Patients admitted with uncomplicated gallstone disease randomized to observation

No interventions assigned to this group

1983 - stones

Patients that in 1983 were diagnosed with gallstones in a population screening

No interventions assigned to this group

1983 - operation

Patients that were operated for gallstone disease at Haukeland University Hospital, Bergen, Norway, in 1983

No interventions assigned to this group

1983 - controls

Patients that were shown not to have gallstones in a 1983 population screening

No interventions assigned to this group

Gallstone patients

Patients with symptoms from gallstone disease

No interventions assigned to this group

Interventions

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Cholecystectomy operation

Cholecystectomy after randomization

Intervention Type PROCEDURE

Other Intervention Names

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Removal of gallbladder

Eligibility Criteria

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Inclusion Criteria

* Symptomatic gallstone disease (SGBS):

Episodes of pain in the right subcostal or midline epigastric area lasting more than 30 min, with ultrasonography signs of gallstones.

* Ultrasonographic: echo with an acoustic shadow in a visible gallbladder, or an echo with positional change and size \<3 mm or, alternatively no demonstrable gallbladder but a strong echo with an acoustic shadow in the position of the gallbladder


* Acute abdominal pain
* Duration of more than 8-12 h
* Tenderness on clinical examination in the upper right quadrant
* Presence of gallbladder stones and signs of inflammation on ultrasonography and in clinical biochemistry data, including an elevated temperature


* Participation in a screening study for gallstones in 1983
* Operated for symptomatic gallstone disease in Bergen, Norway in 1983

Exclusion Criteria

* Infrequent and/or minimal pain that need only very occasional medication
* Age below 18 or above 80
* Not willing to participate


* Severe concomitant disease
* Suspected Common Bile Duct stone
* Acalculous cholecystitis
* Localized peritonitis suggesting gallbladder perforation or gangrenous cholecystitis
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Bergen

OTHER

Sponsor Role collaborator

Haraldsplass Deaconess Hospital

OTHER

Sponsor Role lead

Responsible Party

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Haraldsplass Deaconal Hospital, Department of Surgery, University of Bergen, Bergen, Norway

Principal Investigators

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Karl Søndenaa, MD, PhD

Role: STUDY_CHAIR

Haraldsplass Deaconal Hospital, University of Bergen, Norway

Locations

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Haraldsplass Deaconal Hospital, Department of Surgery

Bergen, , Norway

Site Status

Countries

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Norway

References

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Sondenaa K, Nesvik I, Solhaug JH, Soreide O. Randomization to surgery or observation in patients with symptomatic gallbladder stone disease. The problem of evidence-based medicine in clinical practice. Scand J Gastroenterol. 1997 Jun;32(6):611-6. doi: 10.3109/00365529709025108.

Reference Type BACKGROUND
PMID: 9200296 (View on PubMed)

Glambek I, Kvaale G, Arnesjo B, Soreide O. Prevalence of gallstones in a Norwegian population. Scand J Gastroenterol. 1987 Nov;22(9):1089-94. doi: 10.3109/00365528708991963.

Reference Type BACKGROUND
PMID: 3321395 (View on PubMed)

Vetrhus M, Soreide O, Solhaug JH, Nesvik I, Sondenaa K. Symptomatic, non-complicated gallbladder stone disease. Operation or observation? A randomized clinical study. Scand J Gastroenterol. 2002 Jul;37(7):834-9.

Reference Type BACKGROUND
PMID: 12190099 (View on PubMed)

Vetrhus M, Soreide O, Nesvik I, Sondenaa K. Acute cholecystitis: delayed surgery or observation. A randomized clinical trial. Scand J Gastroenterol. 2003 Sep;38(9):985-90. doi: 10.1080/00365520310004056.

Reference Type BACKGROUND
PMID: 14531537 (View on PubMed)

Vetrhus M, Berhane T, Soreide O, Sondenaa K. Pain persists in many patients five years after removal of the gallbladder: observations from two randomized controlled trials of symptomatic, noncomplicated gallstone disease and acute cholecystitis. J Gastrointest Surg. 2005 Jul-Aug;9(6):826-31. doi: 10.1016/j.gassur.2005.01.291.

Reference Type BACKGROUND
PMID: 15985239 (View on PubMed)

Schmidt M, Smastuen MC, Sondenaa K. Increased cancer incidence in some gallstone diseases, and equivocal effect of cholecystectomy: a long-term analysis of cancer and mortality. Scand J Gastroenterol. 2012 Dec;47(12):1467-74. doi: 10.3109/00365521.2012.719928. Epub 2012 Sep 5.

Reference Type DERIVED
PMID: 22946484 (View on PubMed)

Other Identifiers

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GS06

Identifier Type: -

Identifier Source: org_study_id

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