Cholelithiasis: persistent & new symptoms post cholecystectomy
Background: A Significant proportion of individuals undergoing cholecystectomy for symptomatic cholelithiasis persist with symptoms even after surgery This study focuses on the specificity of symptoms in relation to gall stone disease improvement of symptoms after cholecystectomy, persistence of symptoms & if there is development of any new symptoms. Material & Method: 90 patients with diagnosis of symptomatic gall stone disease undergoing elective cholecystectomy were followed through detailed history for assessment of symptoms. Same set of questionnaire (scale) as well as psychometric analysis were used both pre-operative & post operative period of 1, 3 & 6 month. 10 patients refused to participate so 80 patients were followed up.Results: The mean age (mean + S.D.) of the patient was 43.50 + 10.9 with range of 19 to 70 years ratio of male to female was approximately 1 : 2.5 . 20 patient were under went open cholecystectomy because of all associated co-morbidities. 6 patient were converted to open Cholecystectomy because of adhesion & unclear anatomy Upper abdominal pain (88.8%) fatty food intolerance (82.6%) and nausea & vomiting (72.5%) improved significantly after 6 months (P<0.01) however no significant improvement was observed for dyspepsia (75%).Conclusion :Upper abdominal pain, fatty food intolerance and nausea & vomiting together can be considered as the symptoms specific to gall stone disease these are the symptoms which improve significantly after cholecystectomy . Symptoms of dyspepsia heartburn, regurgitation , abdominal bloating & flatulence are not likely to improve significantly after cholecystectomy though there can be decreases in severity , so patient with more dyspeptic symptoms should be explained about the persistence of symptoms before taking them up for cholecystectomy .
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