{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:26:51Z","timestamp":1772998011139,"version":"3.50.1"},"reference-count":21,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ABCD, arq. bras. cir. dig."],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:p> BACKGROUND: Cholelithiasis is prevalent surgical disease, with approximately 60,000 admissions per year in the Unified Health System in Brazil. Is often asymptomatic or oligosymptomatic and major complications arise from the migration of calculi to low biliary tract. Despite these complications are severe and life threatening, some patients refuse surgical treatment. AIM: To understand why individuals with cholelithiasis refuse cholecystectomy before complications inherent to the presence of gallstones in the bile duct and pancreatitis occur. METHODS: To investigate the universe of the justifications for refusing to submit to surgery it was performed individual interviews according to a predetermined script. In these interviews, was evaluate the knowledge of individuals about cholelithiasis and its complications and the reasons for the refusal of surgical treatment. Were interviewed 20 individuals with cholelithiasis who refused or postponed surgical treatment without a plausible reason. To these interviews, was applied the technique of thematic analysis (Minayo, 2006). RESULTS: The majority of respondents had good knowledge of their disease and its possible complications, were well oriented and had surgical indications by their physicians. The refusal for surgery was justified primarily on negative experiences of themselves or family members with surgery, including anesthesia; fear of pain or losing their autonomy during surgery and postoperative period, preferring to take the risk and wait for complications to then solve them compulsorily. CONCLUSION: The reasons for the refusal to surgical resolution of cholelithiasis were diverse, but closely related to personal (or related persons) negative surgical experiences or complex psychological problems that must be adequately addressed by the surgeon and other qualified professionals.<\/jats:p>","DOI":"10.1590\/s0102-67202014000200007","type":"journal-article","created":{"date-parts":[[2014,7,7]],"date-time":"2014-07-07T17:13:44Z","timestamp":1404753224000},"page":"114-119","source":"Crossref","is-referenced-by-count":4,"title":["Understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis: how to help them in their decision?"],"prefix":"10.1590","volume":"27","author":[{"given":"Adilson","family":"PERON","sequence":"first","affiliation":[{"name":"Faculdade de Ci\u00eancias M\u00e9dicas e da Sa\u00fade"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Laura","family":"SCHLIEMANN","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica de S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando Antonio de","family":"ALMEIDA","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias M\u00e9dicas e da Sa\u00fade"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"issue":"4","key":"ref1","first-page":"165","article-title":"Gallstone disease and its complications","volume":"14","author":"Browning JD","year":"2003","journal-title":"Semin Gastrointest Dis"},{"issue":"5","key":"ref2","first-page":"249","article-title":"Tratamento n\u00e4o cir\u00fargico da lit\u00edase biliar","volume":"44","author":"Conte VP","year":"1989","journal-title":"Rev Hosp Clin Fac Med Sao Paulo"},{"key":"ref3","series-title":"T\u00e9cnica cir\u00fargica: bases anat\u00f4micas, fisiopatol\u00f3gicas e t\u00e9cnicas da cirurgia","author":"Goffi F","year":"2006"},{"issue":"3","key":"ref4","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1097\/00000658-198809000-00003","article-title":"A retrospective analysis of 3 year's experience of an interdisciplinary approach to gallstone disease including shock-waves","volume":"208","author":"Heberer G","year":"1988","journal-title":"Ann Surg"},{"issue":"1","key":"ref5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1590\/S0100-69912001000100006","article-title":"Colecistectomia videolaparosc\u00f3pica ambulatorial","volume":"28","author":"Henriques A","year":"2001","journal-title":"Rev Col Bras Cir"},{"key":"ref6","series-title":"Perdendo o medo da anestesia","author":"Lopes MPSM","year":"2005"},{"issue":"1","key":"ref7","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1002\/1097-0142(19890701)64:1<98::AID-CNCR2820640118>3.0.CO;2-Y","article-title":"Clinicopathologic study of asymptomatic gallbladder carcinoma found at autopsy","volume":"64","author":"Kimura W","year":"1989","journal-title":"Cancer"},{"key":"ref8","series-title":"On death and dying: what the dying have to teach doctors, nurses, clergy, and their own families","author":"Kubler-Ross E","year":"1997"},{"issue":"3","key":"ref9","first-page":"155","article-title":"Laparoscopic cholecystectomy in 960 elderly patients","volume":"38","author":"Loureiro ER","year":"2011","journal-title":"Rev Col Bras Cir"},{"issue":"2","key":"ref10","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1590\/S1807-59322010000200005","article-title":"Are histological alterations observed in the gallbladder precancerous lesions","volume":"65","author":"Meirelles-Costa AL","year":"2010","journal-title":"Clinics"},{"key":"ref11","series-title":"O desafio do conhecimento: pesquisa qualitativa em sa\u00fade","first-page":"p. 303","author":"Minayo M.","year":"2010"},{"key":"ref12","series-title":"Les m\u00e9thodes qualitatives.Cole\u00e7\u00e3o Que sais-je?","author":"Muchielli A","year":"1990"},{"issue":"1","key":"ref13","first-page":"35","article-title":"[Therapy of asymptomatic gallstones: indications and limits]","volume":"57","author":"Picci R","year":"2005","journal-title":"Chir Ital"},{"issue":"3","key":"ref14","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1590\/S0104-42302003000300034","article-title":"Tratamento cir\u00fargico da lit\u00edase vesicular no idoso: an\u00e1lise dos resultados imediatos da colecistectomia por via aberta e videolaparosc\u00f3pica","volume":"49","author":"R\u00e9go RE","year":"2003","journal-title":"Rev Assoc Med Bras"},{"issue":"5","key":"ref15","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1007\/s10620-006-9107-3","article-title":"Asymptomatic cholelithiasis: is cholecystectomy really needed? 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