van Dijk AH, et al. - In this multicentre, randomised, parallel-arm, non-inferiority study involving 1067 patients (aged 18–95 years), researchers compared the non-inferiority of a restrictive strategy with stepwise selection with usual care to evaluate (in)efficient use of cholecystectomy. Study participants included patients with abdominal pain and ultrasound-proven gallstones or sludge. According to findings, suboptimal pain reduction in gallstone and abdominal pain patients has been noted with both usual care and a restrictive cholecystectomy selection strategy. However, fewer cholecystectomies were associated with a restrictive strategy. The findings should encourage doctors involved in the care of gallstone patients to rethink cholecystectomy and to be more careful in advising patients with gallstones and abdominal symptoms on a surgical approach.