Fate of Dyspeptic Symptoms Following Lap. Cholecystectomy.

Abstract

Background: Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstone disease. Symptoms of abdominal pain, nausea, food intolerance, and others are common, and their relationship to biliary disease is often well known but other Gastro-Intestinal conditions may cause them also. Continuation of such symptoms postoperatively is the target of this study. Aim of study: To assess the incidence, etiology, management and preventing measures of persistent dyspeptic symptoms following laparoscopic cholecystectomy. Patients and methods: This is a Prospective study performed in Al-Fallujah teaching hospital on 136 patients undergoing laparoscopic cholecystectomy between September 2016 and September 2017. They were evaluated using a questionnaire for data collection; inquiring about: indication for laparoscopic cholecystectomy, characteristics of pain, and other associated dyspeptic and colonic symptoms. The patients were re-evaluated with the same questionnaires after surgery during a period from 2-12 weeks, and classified into two groups: first group includes patients get benefit of surgery (relieved symptoms) and those whom symptoms not eliminated by surgery (persistent symptoms). 21 patients were excluded from our analysis; five of them had conversion to open surgery & we lost contact with sixteen patients post-operatively. Results: The median age of the remaining 115 patients was 34.4 year (range 17-55) years; 20 were men. All were diagnosed to have symptomatic gall stones disease and all were scheduled for laparoscopic cholecystectomy (L.C.). 16 patients (13.9%) had persistent symptoms post-operatively during the follow-up period. Our study concentrated on the correlation between the preoperative presentation and the continuation of post-operative symptoms. Statistical analysis showed that food intolerance and nausea were more common among those with a poor outcome after laparoscopic cholecystectomy. Patients with persistent dyspeptic symptoms despite operation; their symptoms were indeed belongs to GERD and P.U disease in the majority of them. Conclusion: Nonspecific dyspeptic symptoms like heartburn, food intolerance and nausea are not adequate reasons for taking the decision of laparoscopic cholecystectomy.

Prevalence and predictors of postcholecystectomy syndrome in Nepalese patients after 1 week of laparoscopic cholecystectomy: a cross-sectional study

“…Moreover, the bile duct needed 1–2 weeks to recover from dilatation after surgery. This might be a reason why patients, who had preoperative dyspepsia, might develop new symptoms of dyspepsia after surgery 6 , 18 .…”

“…Almost 90–95% of gallstone cases develop acute cholecystitis and 10–30% of cases lead to life-threatening complications including empyema, gangrene, or perforation 6 . Cholelithiasis can lead to pancreatitis, cholangitis and hepatitis and add its complications.…”