{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T00:38:26Z","timestamp":1760834306836,"version":"build-2065373602"},"reference-count":19,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,10,21]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To examine general practitioners\u2019 (GP) management of cholecystolithiasis and to evaluate persisting abdominal complaints in the years after the diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective analysis of registry data and a subset of individual medical records.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Seventeen primary care practices affiliated with the Radboudumc Practice Based Research Network in the Netherlands.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>633 patients with cholecystolithiasis diagnosed between 2012 and 2016.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>The primary outcome of this study was the healthcare utilisation of patients with cholecystolithiasis diagnosed by the GP in terms of referrals to secondary care, laboratory diagnostics, prescribed medication and the prevalence of concomitant abdominal-related diagnoses in a time interval of 3 years before and 3 years after diagnosis of cholecystolithiasis. For secondary outcomes, electronic medical records were studied from seven practices to assess emergency department visits, operation rates and repeat visits for persistent abdominal symptoms. We compared the non-referred group with the referred group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 57% of patients, concomitant abdominal-related diagnoses were recorded besides the diagnosis cholecystolithiasis. In-depth analyses of 294 patients showed a referral rate of 79.3% (n=233); 62.9% (n=185) underwent cholecystectomy. After referral, 55.4% (129\/233) returned to the GP for persistent abdominal symptoms. Patients returning after referral were more often treated for another abdominal-related diagnosis before cholecystolithiasis was recorded (51.9% vs 28.8%, p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The majority of patients in general practice with gallstones are referred and undergo cholecystectomy. Patients with concomitant abdominal-related diagnoses are likely to return to their physician. GPs should inform patients about these outcomes to improve the shared decision-making process before gallbladder surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-053188","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T12:33:31Z","timestamp":1635942811000},"page":"e053188","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Healthcare utilisation of patients with cholecystolithiasis in primary care: a multipractice comparative analysis"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1012-7991","authenticated-orcid":false,"given":"Floris Martijn","family":"Thunnissen","sequence":"first","affiliation":[{"name":"Surgery, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luuk David","family":"Drager","sequence":"additional","affiliation":[{"name":"Surgery, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Breg","family":"Braak","sequence":"additional","affiliation":[{"name":"Primary and Community Care, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joost P H","family":"Drenth","sequence":"additional","affiliation":[{"name":"Gastroenterology, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelis J H M","family":"van Laarhoven","sequence":"additional","affiliation":[{"name":"Surgery, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9362-9451","authenticated-orcid":false,"given":"Henk J","family":"Schers","sequence":"additional","affiliation":[{"name":"Primary and Community Care, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip R","family":"de Reuver","sequence":"additional","affiliation":[{"name":"Surgery, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,11,3]]},"reference":[{"key":"2025101811324088000_11.11.e053188.1","unstructured":"Health Care Utilisation . Operation for economic Co-operations and development, 2020. Available: https:\/\/stats.oecd.org\/index.aspx?queryid=30167"},{"key":"2025101811324088000_11.11.e053188.2","unstructured":"Nederlandse Vereniging voor Heelkunde (NVvH) . Evidence-Based guideline: diagnostic and treatment of gallstones. Available: https:\/\/richtlijnendatabase.nl\/richtlijn\/galsteenlijden [Accessed Feb 2020]."},{"key":"2025101811324088000_11.11.e053188.3","doi-asserted-by":"crossref","first-page":"16024","DOI":"10.1038\/nrdp.2016.24","article-title":"Gallstones","volume":"2","author":"Lammert","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"2025101811324088000_11.11.e053188.4","doi-asserted-by":"publisher","DOI":"10.1080\/003655200750024560"},{"key":"2025101811324088000_11.11.e053188.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30941-9"},{"key":"2025101811324088000_11.11.e053188.6","doi-asserted-by":"crossref","unstructured":"de Jong JJ , Latenstein CSS , Boerma D . Functional Dyspepsia and Irritable Bowel Syndrome are Highly Prevalent in Patients With Gallstones and are Negatively Associated With Outcomes After Cholecystectomy: A Prospective, Multicentre, Observational Study (PERFECT - Trial). Ann Surg 2020. [Epub ahead of print: 01 Sep 2020].doi:10.1097\/SLA.0000000000004453","DOI":"10.1097\/SLA.0000000000004453"},{"key":"2025101811324088000_11.11.e053188.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"2025101811324088000_11.11.e053188.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.03.005"},{"key":"2025101811324088000_11.11.e053188.9","doi-asserted-by":"publisher","DOI":"10.1080\/00365520310008502"},{"key":"2025101811324088000_11.11.e053188.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2516-9"},{"key":"2025101811324088000_11.11.e053188.11","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1002\/bjs.9887","article-title":"Prospective multicentre cohort study of patient-reported outcomes after cholecystectomy for uncomplicated symptomatic cholecystolithiasis","volume":"102","author":"Lamberts","year":"2015","journal-title":"Br J Surg"},{"key":"2025101811324088000_11.11.e053188.12","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1097\/MEG.0000000000001463","article-title":"Prevalence of dyspepsia in patients with cholecystolithiasis: a systematic review and meta-analysis","volume":"31","author":"Latenstein","year":"2019","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2025101811324088000_11.11.e053188.13","unstructured":"National Institute for Health Research . A randomised controlled trial comparing the clinical effectiveness and cost-effectiveness of laparoscopic cholecystectomy compared with observation\/conservative management for preventing recurrent symptoms and complications in adults with uncomplicated symptomatic gallstones (C-Gall), 2016. Available: https:\/\/www.journalslibrary.nihr.ac.uk\/programmes\/hta\/1419271#\/ [Accessed 21 Dec 2020]."},{"key":"2025101811324088000_11.11.e053188.14","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2011.598548"},{"key":"2025101811324088000_11.11.e053188.15","doi-asserted-by":"publisher","DOI":"10.1159\/000329464"},{"key":"2025101811324088000_11.11.e053188.16","first-page":"574","article-title":"Is biliary pain exclusively related to gallbladder stones? A controlled prospective study","volume":"54","author":"Berger","year":"2004","journal-title":"Br J Gen Pract"},{"key":"2025101811324088000_11.11.e053188.17","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2021.3706","article-title":"A clinical decision tool for selection of patients with symptomatic cholelithiasis for cholecystectomy based on reduction of pain and a Pain-Free state following surgery","volume":"156","author":"Latenstein","year":"2021","journal-title":"JAMA Surg"},{"key":"2025101811324088000_11.11.e053188.18","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1097\/MOG.0000000000000419","article-title":"Indications of cholecystectomy in gallstone disease","volume":"34","author":"Lamberts","year":"2018","journal-title":"Curr Opin Gastroenterol"},{"key":"2025101811324088000_11.11.e053188.19","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1053\/j.gastro.2020.04.014","article-title":"Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation global study","volume":"160","author":"Sperber","year":"2021","journal-title":"Gastroenterology"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-053188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T18:32:48Z","timestamp":1760812368000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-053188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":19,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,3]]},"published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1136\/bmjopen-2021-053188"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-053188","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}