TY - JOUR
T1 - Persistent and new-onset symptoms after cholecystectomy in patients with uncomplicated symptomatic cholecystolithiasis
T2 - A post hoc analysis of 2 prospective clinical trials
AU - Thunnissen, Floris M.
AU - Baars, Cléo
AU - Arts, Rianne
AU - Latenstein, Carmen S. S.
AU - Drenth, Joost P. H.
AU - van Laarhoven, Cornelis J. H. M.
AU - Lantinga, Marten A.
AU - de Reuver, Philip R.
AU - Dutch Gallbladder Research Group
AU - Buyne, Otmar
AU - Donkervoort, Sandra C.
AU - Heisterkamp, Joos
AU - ’t Hof, Klaas in
AU - Jansen, Jan
AU - Nieuwenhuijs, Vincent B.
AU - Schaap, Henk M.
AU - Steenvoorde, Pascal
AU - Boerma, Djamila
AU - Hazebroek, Eric J.
AU - Hirsch, David
AU - Heikens, Joost T.
AU - Konsten, Joop
AU - Polat, Fatih
AU - van der Bilt, Jarmila D. W.
AU - Schreinemakers, Jennifer M. J.
AU - Wiering, Bastiaan
AU - Stockmann, Hein B. A. C.
AU - Boermeester, Marja
N1 - Publisher Copyright: © 2023 The Author(s)
PY - 2023/10
Y1 - 2023/10
N2 - Background: Laparoscopic cholecystectomy is the gold standard for treating biliary colic in patients with gallstones, but post-cholecystectomy abdominal pain is commonly reported. This study investigates which symptoms are likely to persist and which may develop after a cholecystectomy. Methods: Patients from 2 previous prospective trials who underwent laparoscopic cholecystectomy for symptomatic cholecystolithiasis were included. Patients completed questionnaires on pain and gastrointestinal symptoms before surgery and at 6 months follow-up. The prevalence of persistent and new-onset abdominal symptoms was evaluated. Results: A total of 820 patients received cholecystectomy and were included, 75.4% female (n = 616/820) mean age 49.4 years (standard deviation 13.7). At baseline, 74.1% (n = 608/820) of patients met all criteria for biliary colic. Cholecystectomy successfully resolved biliary colic in 94.8% (n = 327/345) of patients, but 36.5% (n = 299/820) of patients reported persistent abdominal pain after 6 months of follow-up. The prevalence of most abdominal symptoms reduced significantly. Symptoms such as flatulence (17.8%, n = 146/820) or restricted eating (14.5%, n = 119/820) persisted most often. New-onset symptoms were frequent bowel movements (9.6%, n = 79/820), bowel urgency (8.5%, n = 70/820), and new-onset diarrhea (8.4%, 69/820). Conclusion: Postcholecystectomy symptoms are mainly flatulence, frequent bowel movements, and restricted eating. Newly reported symptoms are mainly frequent bowel movements, bowel urgency, and diarrhea. The present findings give clinical guidance in informing, managing, and treating patients with symptoms after cholecystectomy.
AB - Background: Laparoscopic cholecystectomy is the gold standard for treating biliary colic in patients with gallstones, but post-cholecystectomy abdominal pain is commonly reported. This study investigates which symptoms are likely to persist and which may develop after a cholecystectomy. Methods: Patients from 2 previous prospective trials who underwent laparoscopic cholecystectomy for symptomatic cholecystolithiasis were included. Patients completed questionnaires on pain and gastrointestinal symptoms before surgery and at 6 months follow-up. The prevalence of persistent and new-onset abdominal symptoms was evaluated. Results: A total of 820 patients received cholecystectomy and were included, 75.4% female (n = 616/820) mean age 49.4 years (standard deviation 13.7). At baseline, 74.1% (n = 608/820) of patients met all criteria for biliary colic. Cholecystectomy successfully resolved biliary colic in 94.8% (n = 327/345) of patients, but 36.5% (n = 299/820) of patients reported persistent abdominal pain after 6 months of follow-up. The prevalence of most abdominal symptoms reduced significantly. Symptoms such as flatulence (17.8%, n = 146/820) or restricted eating (14.5%, n = 119/820) persisted most often. New-onset symptoms were frequent bowel movements (9.6%, n = 79/820), bowel urgency (8.5%, n = 70/820), and new-onset diarrhea (8.4%, 69/820). Conclusion: Postcholecystectomy symptoms are mainly flatulence, frequent bowel movements, and restricted eating. Newly reported symptoms are mainly frequent bowel movements, bowel urgency, and diarrhea. The present findings give clinical guidance in informing, managing, and treating patients with symptoms after cholecystectomy.
UR - http://www.scopus.com/inward/record.url?scp=85169826693&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.surg.2023.06.010
DO - https://doi.org/10.1016/j.surg.2023.06.010
M3 - Article
C2 - 37541808
SN - 0039-6060
VL - 174
SP - 781
EP - 786
JO - Surgery (United States)
JF - Surgery (United States)
IS - 4
ER -