Evaluation of patients undergoing cholecystectomy with special reference to post-cholecystectomy syndrome
DOI:
https://doi.org/10.18203/2349-2902.isj20182245Keywords:
Bile reflux gastritis, Biliary leak, Gall stones, Laparoscopic cholecystectomy, Post-cholecystectomy syndromesAbstract
Background: Significant percentage of patients remain symptomatic even after the cholecystectomy surgery for gall stone disease. Traditionally, this has been termed Post-Cholecystectomy syndrome which may consist of same symptoms for which cholecystectomy was performed or it may be a new set of symptoms that have developed after cholecystectomy. Aim of this study to find out incidence as well as pre-operative, intra-operative and post-operative determinants for the post- cholecystectomy syndrome.
Methods: This is the prospective study, done in the Department of Surgery, Dr BSA Medical College and Hospital, New Delhi. Total 102 number of patients were included in this study, out of which 51 patients underwent open and another 51 patients underwent laparoscopic cholecystectomy.
Results: The mean age of the patients was 40.29±10.69 years with an age range of 19 to 80 years. Incidence rate of post cholecystectomy symptoms were16.66% (n=17). Incidence of post-cholecystectomy syndrome in patients who underwent laparoscopic cholecystectomy were 15.69% (n=8) while in the open cholecystectomy group it was 17.64% (n=9). Out of seventeen symptomatic patients, eight (47.05%) were having the biliary disease while nine patients (52.95%) were having non-biliary cause.
Conclusions: As authors studied present symptomatic group of patients thoroughly, it has become clear that the post-cholecystectomy symptoms are multiple and diverse arising from various causes; which in reality has no relation with the removal of gall bladder. Hence the appellation ‘post-cholecystectomy syndrome is inappropriate and instead we have used the term ‘Post-Cholecystectomy Symptoms’ for these patients.
References
Charles K, Mc Sherry. Cholecystectomy: the gold standard. Am J Surg. 1989;158:174-8.
Pribram BOC. Post cholecystectomy syndromes. JAMA. 1950;142:1262.
Bodvall B. The post cholecystectomy syndromes. Clin. Gastroenterol. 1973;2:103-26.
Christiansen J, Schmidt A. The post cholecystectomy Syndrome. Acta Chir Scand. 1971;137:789-93.
Glen F, Johnson G. Cystic duct stump syndrome. Surgery. 1951;134:249.
Reggiani P, Anzani A, Erenbourg L, Fontana U, Portaleone B. Vercesi M. does post cholecystectomy syndrome exist? Epidemiological features and therapeutic effects of ursodeoxycholic acid. Minerva Med. 1986 Oct;77(38):1755-62.
Silvis SE. What is post cholecystectomy pain syndrome? Gastrointest Endosc. 1985;31:401.
James RLA. Post Cholecystectomy Syndrome. In: Henry L Bockus, eds. Bockus Gastroenterology. 4th edition, WB Saunders Co. 1985:3815-33.
Menlieere P, Vom Meyenfeldt MF, Gouma DJ, Konsten J. Long term follow up after open cholecystectomy. Br J Surg. 1993 Jan;80:100-2.
Bodvall B. Late results following cholecystectomy in 1930 cases and special studies on the post-operative biliary distress. Acta Chir Scand (suppl). 1964;329:1.
Lawrence. Post-operative syndromes. In: Sleisenger MH, ed. Gastrointestinal disease. 4th Ed. Philadelphia, W. B. Saunders co; 1989;2:1730-3.
Johnson G. Relative diagnostic significance of bilirubin and phosphatase values in the post-cholecystectomy syndrome. Acta Chir Scandinav. 1958;115:299-305.
Ruddel WSJ, Ashtou MG, Lintoh DJ, Axon ATR. ERCP in investigation of post-cholecystectomy patients. Lancet. 1980 Mar;1:445-7.
Bar Meir S, Halpern Z. The significance of the diameter of the common bile duct in cholecystectomized patients. Am J Gastroenterol. 1984;79(1):59-60.
Brawn B, Schwerk W. Ultrasonic methods in the differential diagnosis of the post-cholecystectomy syndrome. MMEW. 1977 July;119(29-30):975-8.
Ecsedy G, Mundi B, Farkas I, Huttl K, Forne D, Antony A. The diagnostic value of so called post cholecystectomy bile duct dilatation. Chirurg. 1990 May;61(5):387-91.
Graham MF, Cooperberg PL, Cohen MM and Burhenne HJ. Ultrasonographic screening of the common hepatic duct in symptomatic patients after cholecystectomy. Radiology. 1981Jan;138:137-9.
Bobrov OE, Ogorodnik PV, Loboda DI. Endoscopic papillotomy in patients with post-cholecystectomy syndrome. Klin – Khir. 1991;3:46-8.
Dilawari JB, Chavvla YK, Singhal AK, Kataria S. Post-cholecystectomy syndrome in northern india – study on the diagnostic and therapeutic role of ERCP. Gastroenterol JPN. 1990 Jun;25(3):394-7.
Bradstatter G, Kratochvil P, Wiedner F. The diagnostic significance of endoscopic retrograde cholangio-pancreatography in so called post-cholecystectomy syndrome. Wein – Klin – Wochenschr. 1976 Dec;88(24):806-10.
Zhou PH, Liu FL, Yao LQ, Qin XY. Endoscopic diagnosis and treatment of post-cholecystectomy syndrome. Hepatobiliary Pancreat Dis Int. 2003 Feb;2(1):117-20.
Shirah BH, Shirah HA, Zafar SH, Albeladi KB. Clinical patterns of post cholecystectomy syndrome. Ann Hepatobiliary Pancreat Surg. 2018 Feb;22(1):52-7.
