More accurate diagnosis is shifting surgical practice for abdominal pain and pancreatitis.

• New criteria for dysfunctional gallbladder disorder (DGBD) focus on typical biliary pain and symptom persistence.
• Sphincter of Oddi disorder (SOD) now requires objective evidence of obstruction or pancreatitis.

Surgeons should be cautious, as these disorders are often over-diagnosed, leading to unnecessary risky treatments.

• Ongoing need for better predictors of treatment response, particularly for biliary and pancreatic SOD.