Prospective evaluation of outcome following laparoscopic cholecystectomy in patients with symptomatic gallstone disease.
- Resource Type
- Article
- Authors
- Marwah, Sanjay; Mangal, Hemendra; Singh, Mahavir; Singh, Hardeep; Pandey, Siddharth; Sharma, Himanshu
- Source
- Oncology, Gastroenterology & Hepatology Reports. Jan-Jun2015, Vol. 4 Issue 1, p14-20. 7p.
- Subject
- *CHOLECYSTECTOMY
*GALLBLADDER surgery
*GALLSTONES
*TERTIARY care
*HEALTH outcome assessment
*POSTOPERATIVE period
*DISEASES
- Language
- ISSN
- 2348-3113
Background: Laparoscopic cholecystectomy for gallstones picked up on ultrasonography has become a routine surgical practice. During follow up, symptoms persist in many cases indicating that underlying gallstone disease perse might not be fully responsible for the patient's problems. Aims: To identify various preoperative factors that could predict symptomatic outcome after cholecystectomy. Setting and design: Consecutive patients presenting with symptomatic gallstone disease in a tertiary care center in North India over two years were included in the study. Materials and Methods: All patients underwent elective laparoscopic cholecystectomy and were followed up to six months. Persistence of any pre-operative symptoms or emergence of new symptoms was recorded. Statistical analysis: Chi square test and student t test were used and value of P < 0.05 was consider significant. The significant variables were combined in a logistic regression model to predict the postoperative outcome. The factors for negative as well positive postoperative outcome were identified separately. Results: Fifty two cases undergoing laparoscopic cholecystectomy were subjected to analysis. Preoperatively, all patients had biliary symptoms and 71.16% patients reported both biliary and dyspeptic symptoms. At 6 months follow up, biliary symptoms improved in more than 90% cases while dyspeptic symptoms improved in 88% cases. Highly significant (P < 0.00) preoperative factors for negative post-cholecystectomy outcome were frequent episodes of pain requiring repeated hospitalization whereas typical biliary colic and thickened gallbladder wall seen on ultrasound were predictors of positive outcome ( P < 0.05). Conclusions: Laparoscopic cholecystectomy significantly improves symptoms (especially biliary symptoms) in Asian population. The patients presenting with predominant dyspeptic and non-specific symptoms should be discouraged to undergo cholecystectomy and counseled regarding poor outcome of surgery. [ABSTRACT FROM AUTHOR]