Symptomatic gallstone disease is considered an indication for cholecystectomy. A considerable proportion of patients may experience persistent symptoms after surgery. The purpose of the present study was to find out the rate of symptom persistence after elective laparoscopic cholecystectomy (LC) performed for symptomatic uncomplicated gallstone disease and, in particular, to clarify whether the recurrence rate differs according to the severity of preoperative symptoms.
During a 10-year period (1992–2001), 1,101 patients underwent elective LC at Turku City Hospital for Surgery. A questionnaire concerning the intensity of preoperative symptoms, persistence of symptoms postoperatively, and overall satisfaction with the outcome of the procedure was sent to patients. A total of 677 patients [mean age (range) 59 (21–94) years; 554 (83.1 %) females] with uncomplicated gallstone disease returned the completed form.
Overall, 380 (57 %) patients reported attacks of intense upper abdominal pain, and 287 (43 %) reported episodic mild abdominal symptoms as the prevailing preoperative symptom. Two hundred and forty-eight (37 %) patients continued to have abdominal symptoms after the operation. Among those with predominantly mild abdominal symptoms preoperatively, 119 (41 %) reported the persistence of symptoms after the operation, while in the group with mainly severe upper abdominal pain attacks, 129 (33 %) patients had recurrences (p = 0.052).
According to our data, more than one-third of patients with symptomatic uncomplicated gallstone disease experienced persistent symptoms after elective LC. Patients with mild preoperative symptoms seemed to have more recurrences than those with severe symptoms, although the difference was not statistically significant.
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Shaffer EA (2006) Gallstone disease: epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol 20(6):981–996
Portincasa P, Moschetta A, Petruzzelli M, Palasciano G, Di Ciaula A, Pezzolla A (2006) Gallstone disease: symptoms and diagnosis of gallbladder stones. Best Pract Res Clin Gastroenterol 20(6):1017–1029
Fenster LF, Lonborg R, Thirlby RC, Traverso LW (1995) What symptoms does cholecystectomy cure? Insights from an outcomes measurement project and review of the literature. Am J Surg 169(5):533–538
Luman W, Adams WH, Nixon SN, Mcintyre IM, Hamer-Hodges D, Wilson G et al (1996) Incidence of persistent symptoms after laparoscopic cholecystectomy: a prospective study. Gut 39(6):863–866
Gui GP, Cheruvu CV, West N, Sivaniah K, Fiennes AG (1998) Is cholecystectomy effective treatment for symptomatic gallstones? Clinical outcome after long-term follow-up. Ann R Coll Surg Engl 80(1):25–32
Berger MY, Olde Hartman TC, Bohnen AM (2003) Abdominal symptoms: do they disappear after cholecystectomy? Surg Endosc 17(11):1723–1728
Lublin M, Crawford DL, Hiatt JR, Phillips EH (2004) Symptoms before and after laparoscopic cholecystectomy for gallstones. Am Surg 70(10):863–866
Behar J, Corazziari E, Guelrud M, Hogan W, Sherman S, Toouli J (2006) Functional gallbladder and sphincter of oddi disorders. Gastroenterology 130(5):1498–1509
Mertens MC, De Vries J, Scholtes VP, Jansen P, Roukema JA (2009) Prospective 6 weeks follow-up post-cholecystectomy: the predictive value of pre-operative symptoms. J Gastrointest Surg 13(2):304–311
Jørgensen T (1989) Abdominal symptoms and gallstone disease: an epidemiological investigation. Hepatology 9(6):856–860
Glambek I, Arnesjø B, Søreide O (1989) Correlation between gallstones and abdominal symptoms in a random population: results from a screening study. Scand J Gastroenterol 24(3):277–281
Mertens MC, Roukema JA, Scholtes VP, De Vries J (2010) Risk assessment in cholelithiasis: is cholecystectomy always to be preferred? J Gastrointest Surg 14(8):1271–1279
Thistle JL, Longstreth GF, Romero Y, Arora AS, Simonson JA, Diehl NN et al (2011) Factors that predict relief from upper abdominal pain after cholecystectomy. Clin Gastroenterol Hepatol 9(10):891–896
Weinert CR, Arnett D, Jacobs D, Kane RL (2000) Relationship between persistence of abdominal symptoms and successful outcome after cholecystectomy. Arch Intern Med 160(7):989–995
Finan KR, Leeth RR, Whitley BM, Klapow JC, Hawn MT (2006) Improvement in gastrointestinal symptoms and quality of life after cholecystectomy. Am J Surg 192(2):196–202
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Lill, S., Rantala, A., Karvonen, J. et al. Elective laparoscopic cholecystectomy for symptomatic uncomplicated gallstone disease: do the symptoms disappear?. Surg Endosc 28, 1816–1820 (2014). https://doi.org/10.1007/s00464-013-3391-8
- Laparoscopic cholecystectomy
- Persistent symptoms