{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:51:05Z","timestamp":1791888665124,"version":"4.3.4"},"reference-count":98,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007324","name":"Sundhedsstyrelsen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007324","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Surg"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objective:<\/jats:title>\n                    <jats:p>Gallstones are highly prevalent, and more than 9000 cholecystectomies are performed annually in Denmark. The aim of this guideline was to improve the clinical course of patients with gallstone disease including a subgroup of high-risk patients. Outcomes included reduction of complications, readmissions, and need for additional interventions in patients with uncomplicated gallstone disease, acute cholecystitis, and common bile duct stones (CBDS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>An interdisciplinary group of clinicians developed the guideline according to the GRADE methodology. Randomized controlled trials (RCTs) were primarily included. Non-RCTs were included if RCTs could not answer the clinical questions. Recommendations were strong or weak depending on effect estimates, quality of evidence, and patient preferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>For patients with acute cholecystitis, acute laparoscopic cholecystectomy is recommended (16 RCTs, strong recommendation). Gallbladder drainage may be used as an interval procedure before a delayed laparoscopic cholecystectomy in patients with temporary contraindications to surgery and severe acute cholecystitis (1 RCT and 1 non-RCT, weak recommendation). High-risk patients are suggested to undergo acute laparoscopic cholecystectomy instead of drainage (1 RCT and 1 non-RCT, weak recommendation). For patients with CBDS, a one-step procedure with simultaneous laparoscopic cholecystectomy and CBDS removal by laparoscopy or endoscopy is recommended (22 RCTs, strong recommendation). In high-risk patients with CBDS, laparoscopic cholecystectomy is suggested to be included in the treatment (6 RCTs, weak recommendation). For diagnosis of CBDS, the use of magnetic resonance imaging or endoscopic ultrasound prior to surgical treatment is recommended (8 RCTs, strong recommendation). For patients with uncomplicated symptomatic gallstone disease, observation is suggested as an alternative to laparoscopic cholecystectomy (2 RCTs, weak recommendation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Seven recommendations, four weak and three strong, for treating patients with symptomatic gallstone disease were developed. Studies for treatment of high-risk patients are few and more are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Endorsement:<\/jats:title>\n                    <jats:p>The Danish Surgical Society.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14574969221111027","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T08:09:57Z","timestamp":1661328597000},"page":"11-30","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["National clinical practice guidelines for the treatment of symptomatic gallstone disease: 2021 recommendations from the Danish Surgical Society"],"prefix":"10.1177","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9415-3443","authenticated-orcid":false,"given":"Daniel M\u00f8nsted","family":"Shabanzadeh","sequence":"first","affiliation":[{"name":"Bispebjerg Hospital Digestive Disease Center Bispebjerg Bakke 23 DK-2400 Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorthe Wiinholdt","family":"Christensen","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Surgical Section, Bispebjerg Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Ewertsen","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Friis-Andersen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Regionshospitalet Horsens, Horsens, DenmarkInstitute for Clinical Medicine, Faculty of Health, University of Aarhus, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Helgstrand","sequence":"additional","affiliation":[{"name":"Department of Surgery, Zealand University Hospital, K\u00f8ge, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Nannestad J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Surgical Section, Bispebjerg Hospital, Copenhagen, DenmarkInstitute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Kirkegaard-Klitbo","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Surgical Section, Bispebjerg Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders Christian","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, DenmarkDepartment of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas Sanberg","family":"Ljungdalh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palle","family":"Nordblad Schmidt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Gastrointestinal Surgery, Hvidovre Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke","family":"Therkildsen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Vilmann","sequence":"additional","affiliation":[{"name":"Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, DenmarkDepartment of Surgery, Herlev Gentofte Hospital, Herlev, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes Sefland","family":"Vogt","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars Tue","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Surgical Section, Bispebjerg Hospital, Copenhagen, DenmarkInstitute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"bibr1-14574969221111027","unstructured":"NOMESCO: Health statistics for the Nordic countries 2017, 2017, http:\/\/norden.diva-portal.org\/smash\/record.jsf?pid=diva2%3A1148509&dswid=-1400"},{"key":"bibr2-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.03.005"},{"key":"bibr3-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.01.025"},{"key":"bibr4-14574969221111027","author":"Sundhedsstyrelsen","year":"2006","journal-title":"Sundhedsstyrelsen, K\u00f8benhavn"},{"key":"bibr5-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000418"},{"key":"bibr6-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114728"},{"key":"bibr7-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.09.002"},{"key":"bibr8-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.515"},{"key":"bibr9-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-020-00336-x"},{"key":"bibr10-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420220069008"},{"key":"bibr11-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1055\/a-0862-0346"},{"key":"bibr12-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.09.041"},{"key":"bibr13-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000000216"},{"key":"bibr14-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2008.0428"},{"issue":"3","key":"bibr15-14574969221111027","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1007\/s00464-013-3237-4","volume":"28","author":"Bansal VK","year":"2014","journal-title":"Surg Endosc"},{"key":"bibr16-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60990-8"},{"key":"bibr17-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2516-9"},{"key":"bibr18-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1080\/00365529850166130"},{"key":"bibr19-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.143.6.533"},{"key":"bibr20-14574969221111027","doi-asserted-by":"crossref","DOI":"10.1007\/s00464-017-5790-8","volume":"32","author":"Kohn J","year":"2018","journal-title":"Surg Endosc"},{"key":"bibr21-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.516"},{"key":"bibr22-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2016.2059"},{"key":"bibr23-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.470"},{"key":"bibr24-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7690"},{"key":"bibr25-14574969221111027","unstructured":"Sundhedsstyrelsen: National Klinisk retningslinje for behandling af symptomatisk galdestenssygdom, www.sst.dk\/da\/Opgaver\/Patientforloeb-og-kvalitet\/Nationale-kliniske-retningslinjer-NKR\/Puljefinansierede-NKR\/National-Klinisk-retningslinje-for-behandling-af-symptomatisk-galdestenssygdom2022 (accessed 25 May 2022)."},{"key":"bibr26-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"bibr27-14574969221111027","volume":"355","author":"Sterne JA","year":"2016","journal-title":"BMJ"},{"key":"bibr28-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-017-3917-7"},{"key":"bibr29-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-016-3854-x"},{"key":"bibr30-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1080\/gas.37.7.834.839"},{"key":"bibr31-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1080\/00365520310008502"},{"key":"bibr32-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1159\/000329464"},{"key":"bibr33-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30941-9"},{"key":"bibr34-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1998.00708.x"},{"key":"bibr35-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199804000-00001"},{"key":"bibr36-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-255X(03)00065-9"},{"key":"bibr37-14574969221111027","doi-asserted-by":"publisher","DOI":"10.3126\/kumj.v7i1.1759"},{"key":"bibr38-14574969221111027","first-page":"778","volume":"8","author":"Zahur S","year":"2014","journal-title":"Pak J Med Health Sci"},{"key":"bibr39-14574969221111027","first-page":"538","volume":"10","author":"Razzaq M","year":"2016","journal-title":"Pak J Med Health Sci"},{"key":"bibr40-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1159\/000081352"},{"key":"bibr41-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-003-9230-6"},{"key":"bibr42-14574969221111027","first-page":"1039","volume":"10","author":"Akhtar N","year":"2016","journal-title":"Pak J Med Health Sci"},{"key":"bibr43-14574969221111027","doi-asserted-by":"publisher","DOI":"10.4103\/1947-2714.115783"},{"key":"bibr44-14574969221111027","first-page":"486107","volume":"2013","author":"Verma S","year":"2013","journal-title":"Minim Invasive Surg"},{"key":"bibr45-14574969221111027","first-page":"162643","volume":"2014","author":"Saber A","year":"2014","journal-title":"Minim Invasive Surg"},{"key":"bibr46-14574969221111027","first-page":"328","volume":"117","author":"Rajcok M","year":"2016","journal-title":"Bratisl Lek Listy"},{"key":"bibr47-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182a1599b"},{"key":"bibr48-14574969221111027","doi-asserted-by":"publisher","DOI":"10.9738\/INTSURG-D-13-00068.1"},{"key":"bibr49-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001886"},{"key":"bibr50-14574969221111027","first-page":"972","volume":"12","author":"Mahmood K","year":"2018","journal-title":"Pak J Med Health Sci"},{"key":"bibr51-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-016-3304-y"},{"key":"bibr52-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-015-0294-2"},{"key":"bibr53-14574969221111027","volume":"363","author":"Loozen CS","year":"2018","journal-title":"BMJ"},{"key":"bibr54-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.06.066"},{"key":"bibr55-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-010-0891-7"},{"key":"bibr56-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-014-2467-7"},{"key":"bibr57-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-010-1348-8"},{"key":"bibr58-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2013.02.004"},{"key":"bibr59-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-005-0356-6"},{"key":"bibr60-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-017-1232-9"},{"key":"bibr61-14574969221111027","first-page":"171201","volume":"83","author":"Liu Z","year":"2017","journal-title":"Am Surg"},{"key":"bibr62-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-4918-6"},{"key":"bibr63-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000246913.74870.fc"},{"key":"bibr64-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.02.021"},{"key":"bibr65-14574969221111027","doi-asserted-by":"publisher","DOI":"10.4103\/0972-9941.134877"},{"key":"bibr66-14574969221111027","doi-asserted-by":"publisher","DOI":"10.18203\/2349-2902.isj20192943"},{"key":"bibr67-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182456ec0"},{"key":"bibr68-14574969221111027","first-page":"20","volume":"63","author":"Bandeh-Moghadam H","year":"2010","journal-title":"Rev Venez Cirugia"},{"issue":"11","key":"bibr69-14574969221111027","volume":"4","author":"Barreras Gonzalez JE","year":"2016","journal-title":"Endosc Int Open"},{"key":"bibr70-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s004649901145"},{"key":"bibr71-14574969221111027","volume-title":"Advances in Endoscopic Surgery","author":"Ferulano G","year":"2011"},{"key":"bibr72-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-944617"},{"key":"bibr73-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2009.226"},{"issue":"4","key":"bibr74-14574969221111027","first-page":"467","volume":"57","author":"Sgourakis G","year":"2002","journal-title":"Minerva Chir"},{"key":"bibr75-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.10.015"},{"key":"bibr76-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800821121"},{"key":"bibr77-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajg.2014.01.005"},{"key":"bibr78-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.133.7.702"},{"key":"bibr79-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)91413-0"},{"key":"bibr80-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09896-3"},{"key":"bibr81-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2007.07.025"},{"key":"bibr82-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12481"},{"key":"bibr83-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2008.05.023"},{"key":"bibr84-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-966264"},{"key":"bibr85-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(05)00619-1"},{"key":"bibr86-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2005.02.028"},{"key":"bibr87-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.7587"},{"key":"bibr88-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-015-0581-4"},{"key":"bibr89-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-6092-5"},{"key":"bibr90-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-319996"},{"key":"bibr91-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-016-3223-y"},{"key":"bibr92-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318228d31c"},{"key":"bibr93-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-006-0169-2"},{"key":"bibr94-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s004649900409"},{"key":"bibr95-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-039781"},{"key":"bibr96-14574969221111027","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-044281","volume":"11","author":"Clout M","year":"2021","journal-title":"BMJ Open"},{"key":"bibr97-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-015-1322-y"},{"key":"bibr98-14574969221111027","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-019-01802-0"}],"container-title":["Scandinavian Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14574969221111027","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14574969221111027","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14574969221111027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:58:58Z","timestamp":1777697938000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14574969221111027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,24]]},"references-count":98,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1177\/14574969221111027"],"URL":"https:\/\/doi.org\/10.1177\/14574969221111027","relation":{},"ISSN":["1457-4969","1799-7267"],"issn-type":[{"value":"1457-4969","type":"print"},{"value":"1799-7267","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,24]]}}}