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You don't need surgery "just in case." What watchful waiting involves in practice: No restriction on diet, although some patients find that limiting very fatty meals reduces the chance of triggering an episode Awareness of the symptoms to watch for: severe upper-right or upper-central abdominal pain, pain radiating to the right shoulder, nausea and vomiting, jaundice, or fever Prompt review if any of those symptoms develop When earlier surgery is reasonable Conversely, there are valid reasons to choose elective cholecystectomy even without high-risk features: Practical: planning surgery on your terms (around work, travel, family) is preferable to an emergency admission Geographic or lifestyle: frequent travel to areas with limited healthcare access raises the threshold for "wait and see" Risk aversion: some patients place high weight on eliminating future uncertainty Concurrent surgery: if another abdominal procedure is planned, combining can make sense Neither approach is "right." Both are reasonable

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Half of the dose (with some excess) was given in a canister at visit 4 after randomization