Factors relevant to persistent upper abdominal pain after cholecystectomy

HPB (Oxford). 2017 Jul;19(7):629-637. doi: 10.1016/j.hpb.2017.04.003. Epub 2017 May 8.

Abstract

Background: Cholecystectomy is a routine procedure for treatment of upper abdominal pain (UAP) and other atypical symptoms associated with gallstones. UAP, however, persists in some cases postoperatively. The present study was to identify the risk factors relevant to persistent UAP after cholecystectomy.

Methods: 1714 symptomatic patients undergoing cholecystectomy for gallstones were enrolled. All the patients were asked to complete a biliary symptom questionnaire. The risk factors for persistent postcholecystectomy UAP and features related to sustained relief of postcholecystectomy UAP were evaluated.

Results: 172 (10%) patients complained UAP after cholecystectomy. In multivariate analysis, female gender, preoperative UAP occurring >24h before admission, and each episode of UAP >30min were independently associated with persistent postoperative UAP (all p < 0.05). 132 (76.7%) patients reported sustained relief of postcholecystectomy UAP, the causes of which remained unknown but were attributed to functional postcholecystectomy syndrome. Shorter duration of preoperative UAP (occurring within 24 h before admission), less frequency of postoperative UAP (≤1 episode per day) and administration of choleretic medications were independently associated with postoperative UAP relief (all p < 0.05).

Conclusion: Females with longer historical and more frequent preoperative UAP are more likely to develop postcholecystectomy UAP. Choleretic medications are effective in relieving postoperative UAP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology*
  • Abdominal Pain / prevention & control
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Cholagogues and Choleretics / therapeutic use
  • Cholecystectomy / adverse effects*
  • Female
  • Gallstones / complications
  • Gallstones / diagnosis
  • Gallstones / surgery*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Pain Measurement
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / etiology*
  • Pain, Postoperative / prevention & control
  • Risk Factors
  • Sex Factors
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Cholagogues and Choleretics