Condition

Gallbladder and biliary diseases

Clinical trials and treatment information for Gallbladder and biliary diseases

251.6M
People Affected
150
Active Trials
15.1M
New Cases/Year
131K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Laparoscopic Cholecystectomy
95% Effectiveness• 95% Confidence• 65% Safety• 139 trials• 5M participants
HIGH EvidenceExcellent Value
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Comparative Safety Scale(Higher is safer)

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65
DangerousModerateSafe

Time to Effect

Immediate post-recovery

Duration

One-time procedure, 2-4 week recovery

Response Rate

95%

Remission Rate

90%

Common Side Effects:

Post-operative pain: 90%
Nausea and vomiting: 40%
Shoulder pain (referred): 50%
Bile duct injury: 0.5%
Infection (wound/abdominal): 3%
Bleeding: 0.2%
Post-cholecystectomy syndrome: 15%

Annual Cost of Care

Drug Cost

$100

Monitoring

$300

Side Effects

$200

Total Annual

$15,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

1

Cost per Remission

$16,667

Cost per Responder

$15,789

Treatment Outcomes
Primary Outcomes
Biliary Colic Episode FrequencyAverage 3-4 episodes per month
-95% (Reduction to <1 episode per 3 months)
Recurrence of Acute CholecystitisAnnual recurrence rate of 30-50% without surgery
-99% (Elimination of gallbladder-related acute cholecystitis (reduction to <1% annual risk))
Incidence of Gallstone-Related Pancreatitis or CholangitisAnnual incidence of 10-15% for high-risk patients
-95% (Reduction of annual incidence by 10-15 percentage points)
Abdominal Pain Severity (VAS scale)VAS score: 7/10 (average during symptomatic periods)
-85% (-6 points on VAS scale)
Secondary Benefits
Gastrointestinal Quality of Life Index (GIQLI) ScoreGIQLI Score: 70/144 (lower scores mean worse QoL)
+25% (+17-20 points)
ER Visits/Hospitalizations for Biliary SymptomsAverage 1.5 visits/year
-98% (-1.5 visits/year (reduction to near zero))
Post-Meal Discomfort/Food Intolerance ScoreAverage 6/10 (0=none, 10=severe)
-80% (-4-5 points)
Common Side Effects
Post-operative pain
+90%
Nausea and vomiting
+40%
Shoulder pain (referred)
+50%

Clinical Trial Phases:

Phase 4
2
Endoscopic Retrograde Cholangiopancreatography (ERCP)
92% Effectiveness• 90% Confidence• 58% Safety• 33 trials• 300K participants
HIGH EvidenceExcellent Value
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Comparative Safety Scale(Higher is safer)

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58
DangerousModerateSafe

Time to Effect

Immediate

Duration

One-time procedure (may require repeat)

Response Rate

95%

Remission Rate

90%

Common Side Effects:

Post-ERCP pancreatitis: 7%
Bleeding: 1.5%
Perforation: 0.3%
Cholangitis: 0.5%

Annual Cost of Care

Drug Cost

$50

Monitoring

$250

Side Effects

$500

Total Annual

$10,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.8

Cost per Remission

$11,111

Cost per Responder

$10,526

Treatment Outcomes
Primary Outcomes
Total Bilirubin8.5 mg/dL
-80% (-6.8 mg/dL)
Alkaline Phosphatase650 U/L
-70% (-455 U/L)
Pain Severity (VAS Scale)VAS Score: 8/10
-75% (-6 points on VAS)
White Blood Cell Count16 x10^9/L
-50% (-8 x10^9/L)
Secondary Benefits
Gastrointestinal Quality of Life Index (GIQOL)GIQOL Score: 70/144
+40% (+28 points on GIQOL)
Serum Amylase1200 U/L
-90% (-1080 U/L)
Pruritus Severity (NRS)NRS Score: 7/10
-85% (-6 points on NRS)
Common Side Effects
Post-ERCP pancreatitis
+7%
Bleeding
+1.5%
Perforation
+0.3%

Clinical Trial Phases:

Phase 4
3
Antibiotics (e.g., Piperacillin-tazobactam)
90% Effectiveness• 90% Confidence• 70% Safety• 1 trials• 100K participants
HIGH EvidenceExcellent ValueDose: Piperacillin-tazobactam 3.375g IV q6h
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Comparative Safety Scale(Higher is safer)

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70
DangerousModerateSafe

Time to Effect

1-3 days

Duration

7-14 days per episode

Response Rate

90%

Remission Rate

%

Number Needed to Treat (NNT)

3

Common Side Effects:

Nausea and vomiting: 15%
Diarrhea: 20%
Allergic reaction (rash): 3%
Clostridioides difficile infection: 2%

Annual Cost of Care

Drug Cost

$1,500

Monitoring

$100

Side Effects

$200

Total Annual

$5,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.6

Cost per Responder

$5,556

Treatment Outcomes
Primary Outcomes
Abdominal Pain SeverityNRS 7/10
-71.43% (-5 points)
White Blood Cell Count15 x 10^9/L
-46.67% (-7 x 10^9/L)
C-reactive protein (CRP)50 mg/L
-80% (-40 mg/L)
Body Temperature39.0 °C
-5.13% (-2.0 °C)
Secondary Benefits
Nausea SeverityNRS 6/10
-83.33% (-5 points)
Total Bilirubin Level3.0 mg/dL
-73.33% (-2.2 mg/dL)
Length of Hospital Stay7 days
-57.14% (-4 days)
Common Side Effects
Nausea and vomiting
+15%
Diarrhea
+20%
Allergic reaction (rash)
+3%

Clinical Trial Phases:

Phase 4
4
Ursodeoxycholic Acid (UDCA)
60% Effectiveness• 85% Confidence• 88% Safety• 8 trials• 50K participants
HIGH EvidenceModerate ValueDose: 8-10 mg/kg/day, usually 300-600mg BID
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Comparative Safety Scale(Higher is safer)

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88
DangerousModerateSafe

Time to Effect

6-12 months for dissolution

Duration

6 months - 2 years for dissolution, long-term for prevention

Response Rate

55%

Remission Rate

55%

Number Needed to Treat (NNT)

7

Number Needed to Harm (NNH)

500

Common Side Effects:

Diarrhea: 8%
Abdominal pain: 3%
Nausea: 2%
Pruritus (itching): 1%

Annual Cost of Care

Drug Cost

$780

Monitoring

$500

Side Effects

$50

Total Annual

$1,330

Cost-Effectiveness

MODERATE

QALYs Gained

0.2

Cost per Remission

$2,418

Cost per Responder

$2,418

Treatment Outcomes
Primary Outcomes
Serum Alkaline Phosphatase (ALP)350 U/L
-43% (-150 U/L)
Total Bilirubin1.5 mg/dL
-20% (-0.3 mg/dL)
Pruritus SeverityPruritus severity (NRS 0-10): 7/10
-35% (-2.5 points on NRS)
Cholesterol Gallstone Size10 mm diameter
-40% (-4 mm diameter)
Secondary Benefits
Serum Gamma-Glutamyl Transferase (GGT)200 U/L
-35% (-70 U/L)
Fatigue SeverityFatigue severity (NRS 0-10): 6/10
-15% (-0.9 points on NRS)
Total Serum Bile Acids40 µmol/L
-50% (-20 µmol/L)
Common Side Effects
Diarrhea
+8%
Abdominal pain
+3%
Nausea
+2%

Clinical Trial Phases:

Phase 4