Indications for Gallbladder Surgery in Gallstone Disease

Inclusion criteria: * Symptomatic gallstone disease (SGBS): Episodes of pain in the right subcostal or midline epigastric area lasting more than 30 min, with ultrasonography signs of gallstones. * Ultrasonographic: echo with an acoustic shadow in a visible gallbladder, or an echo with positional change and size \<3 mm or, alternatively no demonstrable gallbladder but a strong echo with an acoustic shadow in the position of the gallbladder Exclusion Criteria SGBS: * Infrequent and/or minimal pain that need only very occasional medication * Age below 18 or above 80 * Not willing to participate Inclusion criteria, acute cholecystitis (AC): * Acute abdominal pain * Duration of more than 8-12 h * Tenderness on clinical examination in the upper right quadrant * Presence of gallbladder stones and signs of inflammation on ultrasonography and in clinical biochemistry data, including an elevated temperature Exclusion criteria, AC: * Severe concomitant disease * Suspected Common Bile Duct stone * Acalculous cholecystitis * Localized peritonitis suggesting gallbladder perforation or gangrenous cholecystitis Inclusion criteria 1983 cohort of patients: * Participation in a screening study for gallstones in 1983 * Operated for symptomatic gallstone disease in Bergen, Norway in 1983