What symptoms does cholecystectomy cure? Insights from an outcomes measurement project and review of the literature.
BACKGROUND
The increasing application of cholecystectomy has increased the need to assess the effects of cholecystectomy on presenting symptoms.


METHODS
Three surgeon-derived and two patient-derived data forms were collected for each patient in a series of 225 laparoscopic cholecystectomies.


RESULTS
Eighty-two percent of patients had documented gallstones preoperatively, 91% had biliary pain, and 77% had both biliary pain and documented gallstones prior to surgery. Fifteen percent of patients were believed to have acalculous cholecystitis. Eighty-two percent also had bothersome nonpain symptoms (gassiness, bloating, indigestion, fatty-food intolerance, and nausea). The cure rate for biliary colic was 82% if stones were documented preoperatively, and 52% when they were not (P = 0.002). Atypical pain was cured 80% of the time, and nonpain symptoms, 44% of the time.


CONCLUSIONS
Most patients (82%) with biliary colic and gallstones have complete relief of upper abdominal pain after cholecystectomy. Pain relief in patients felt to have acalculous cholecystitis was only 52%. Nonpain symptoms were common preoperatively (82%) and were relieved in 44% of patients.
Fenster
L F
LF
Office of Value Assessment, Virginia Mason Medical Center, Seattle, Washington 98111, USA.
Lonborg
R
R
Thirlby
R C
RC
Traverso
L W
LW
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D017081:Cholecystectomy, Laparoscopic; D002764:Cholecystitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002769:Cholelithiasis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002908:Chronic Disease; D003085:Colic / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011300:Preoperative Care; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome