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Journal of Gastrointestinal Surgery

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Open Access 01-08-2010 | Original Article

Risk Assessment in Cholelithiasis: Is Cholecystectomy Always to be Preferred?

Authors: Marlies C. Mertens, Jan A. Roukema, Vincent P. W. Scholtes, Jolanda De Vries

Published in: Journal of Gastrointestinal Surgery | Issue 8/2010

Abstract

Background

As many patients with gallstone disease do not benefit from cholecystectomy, preoperative recognition of such high-risk patients is important. The aim of the study is to identify predictors of persisting symptoms at 6 months after cholecystectomy for patients with different preoperative symptomatology.

Method

Participants in this prospective study were consecutive patients (n = 172), age 18–65 years, with symptomatic cholelithiasis, undergoing a laparoscopic cholecystectomy. Predictors were identified using uni- and multivariate regression analyses.

Results

At 6 months postcholecystectomy, patients with only preoperative biliary symptoms were most often free of symptoms (62.5%). Patients with only dyspeptic symptoms most often reported persistence of preexisting symptoms (63.2%). Preoperative non-specific symptoms predicted the report of postoperative biliary and/or dyspeptic symptoms (OR = 4.5–6.1). Persistence of preexisting pattern of symptoms was predicted by the use of psychotropic medication (OR = 5.3) and dyspeptic symptoms (OR = 4.5). Postoperative biliary symptoms were predicted by High Trait Anxiety (HTA) (OR = 10.6).

Conclusion

Surgeons should take account of individual risks of patients in the management of cholelithiasis. Instead of cholecystectomy, expectative management should be the first choice in patients with non-specific symptoms, with dyspeptic symptoms only, with HTA and in patients using psychotropic medication.

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Title: Risk Assessment in Cholelithiasis: Is Cholecystectomy Always to be Preferred?
Authors: Marlies C. Mertens
Jan A. Roukema
Vincent P. W. Scholtes
Jolanda De Vries
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 8/2010
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-010-1219-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk Assessment in Cholelithiasis: Is Cholecystectomy Always to be Preferred?

Abstract

Background

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusion

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