Commentary
See article on page 889Post-cholecystectomy diarrhoea: a running commentary
| The first 150 words of the full text of this article appear below. |
Since laparoscopic cholecystectomy eclipsed the open procedure
in the early 1990s there has been a worldwide increase in annual cholecystectomy rates of between 20% and 50%.1 2 This
has occurred despite a lack of evidence that gallstone incidence has increased to the same degree. Laparoscopic cholecystectomy has a lower
mortality rate than open cholecystectomy, but in view of the increased
cholecystectomy rate, there may be no decrease in the total number of
deaths associated with this operation.1 Changed
indications for a safer procedure and patient or physician induced
demand may explain the increased cholecystectomy rate. Patients and
doctors may have a lower threshold for tolerance of gallstone
associated symptoms than in the pre-laparoscopic era. As gallstones may
be associated with a spectrum of symptoms, from none at all to those
associated with life-threatening complications, in many instances the
decision to operate may be arbitrary. This is especially so as the
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