Prevalence and Determinants of Persistent Dyspeptic Symptoms after Elective Laparoscopic Cholecystectomy Adil Rahman Faraj Al-Budaerany* FICMS, Muatez Mundhir Manhal* FIBMS, Jaber Qataa Jaber Al-Mohammedawi* FICMS
Background: Gallbladder diseases can give rise to dyspeptic or colonic symptoms. With the introduction of laparoscopic cholecystectomy, one could expect a decrease of the prevalence of post-cholecystectomy symptoms owing to advantages of minimally invasive techniques causing fewer adhesions and scar related problems
Objectives: To evaluate the fate of dyspeptic symptoms after laparoscopic cholecystectomy and to identify the factors associated with persistent dyspepsia.
Methods: A randomized prospective study that was conducted in the surgical unit, department of surgery, Al-Khidhir Hospital in Al-Muthanna province during a period of 18 months from Jan 2017 to July 2018. It included all patients visiting the outpatient clinic and emergency unit due to dyspeptic symptoms, then the assessment was done by different surgeons in the same surgical team in the hospital, and laparoscopic cholecystectomy scheduled for them. Patients who converted to open surgery or those who were unable to cooperate in answering the questionnaires post-operatively were excluded from the study. The total number of included patients was 100. Postoperative Reevaluation of the patients for the presence of dyspeptic symptoms was done in the outpatient clinic for three to four months.
Results: Preoperative symptoms were persisted postoperatively in 23% of study patients, most of these symptoms were dyspeptic symptoms (82.6%). Persistent symptoms were significantly associated with high body mass index level, smoking, and alcohol drinking (34.3%, P= 0.011 in obese; 52.2%, P= 0.001 in smokers; and 50%, P= 0.019 in alcohol drinkers).
Conclusion: Approximately three quarters of patients who underwent gallbladder surgery showed improvement in their abdominal symptoms irrespective of the cause. A modifiable associated factors for persistent symptoms were obesity, smoking, and alcohol drinking
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