BACKGROUND: Cholecystectomy is the preferred treatment option for symptomatic gallstones, but the exact relationship between cholecystectomies and symptoms still is unclear. This study aimed to assess the effectiveness of elective cholecystectomy for patients with cholecystolithiasis in terms of both persistent and de novo symptoms. METHODS: A systematic literature search was conducted in Pubmed and Embase. The search included studies comprising patients 18 years of age or older undergoing elective cholecystectomy for symptomatic cholecystolithiasis. The proportions of symptoms after cholecystectomy were calculated and then subdivided into persistent and de novo symptoms. RESULTS: A total of 38 studies reported the presence of postcholecystectomy symptoms. The results showed that upper abdominal pain, the main indication for cholecystectomy in the majority of the patients, mostly disappeared after surgery. However, it persisted in up to 33 % of the patients and arose de novo in up to 14 %. Diarrhea (85 %) and constipation (76 %) were the persistent symptoms most often reported, whereas upper abdominal pain and vomiting were the least often reported. Flatulence (62 %) was the most often reported new symptom. However, large variations in symptoms were found between studies. CONCLUSIONS: The review indicates that cholecystectomy often is ineffective with regard to persistent and de novo symptoms. The finding that the types and proportions of persistent symptoms differ from those that arise de novo suggests that this distinction may be useful in predicting which patients would and which would not benefit from a cholecystectomy.
BACKGROUND: Cholecystectomy is the preferred treatment option for symptomatic gallstones, but the exact relationship between cholecystectomies and symptoms still is unclear. This study aimed to assess the effectiveness of elective cholecystectomy for patients with cholecystolithiasis in terms of both persistent and de novo symptoms. METHODS: A systematic literature search was conducted in Pubmed and Embase. The search included studies comprising patients 18 years of age or older undergoing elective cholecystectomy for symptomatic cholecystolithiasis. The proportions of symptoms after cholecystectomy were calculated and then subdivided into persistent and de novo symptoms. RESULTS: A total of 38 studies reported the presence of postcholecystectomy symptoms. The results showed that upper abdominal pain, the main indication for cholecystectomy in the majority of the patients, mostly disappeared after surgery. However, it persisted in up to 33 % of the patients and arose de novo in up to 14 %. Diarrhea (85 %) and constipation (76 %) were the persistent symptoms most often reported, whereas upper abdominal pain and vomiting were the least often reported. Flatulence (62 %) was the most often reported new symptom. However, large variations in symptoms were found between studies. CONCLUSIONS: The review indicates that cholecystectomy often is ineffective with regard to persistent and de novo symptoms. The finding that the types and proportions of persistent symptoms differ from those that arise de novo suggests that this distinction may be useful in predicting which patients would and which would not benefit from a cholecystectomy.
Authors: L Borly; I B Anderson; L Bardram; E Christensen; A Sehested; H Kehlet; P Matzen; J F Rehfeld; P Stage; D B Toftdahl; A Gernow; L Højgaard Journal: Scand J Gastroenterol Date: 1999-11 Impact factor: 2.423
Authors: P W Plaisier; R L van der Hul; H G Nijs; R den Toom; O T Terpstra; H A Bruining Journal: Am J Gastroenterol Date: 1994-05 Impact factor: 10.864
Authors: Mark P Lamberts; Brenda L Den Oudsten; Frederik Keus; Jolanda De Vries; Cornelis J H M van Laarhoven; Gert P Westert; Joost P H Drenth; Jan A Roukema Journal: Surg Endosc Date: 2014-06-21 Impact factor: 4.584
Authors: Mary Amanda Dew; Andrea F DiMartini; Daniela P Ladner; Mary Ann Simpson; Elizabeth A Pomfret; Brenda W Gillespie; Robert M Merion; Jarcy Zee; Abigail R Smith; Susan Holtzman; Averell H Sherker; Robert Weinrieb; Robert A Fisher; Jean C Emond; Chris E Freise; James R Burton; Zeeshan Butt Journal: Transplantation Date: 2016-06 Impact factor: 4.939
Authors: Carmen S S Latenstein; Bob J van Wely; Mieke Klerkx; Marjan J Meinders; Bastiaan Thomeer; Philip R de Reuver Journal: World J Surg Date: 2019-09 Impact factor: 3.352
Authors: Alexia Farrugia; Joseph Anthony Attard; Stuart Hanmer; Stuart Bullock; Siobhan McKay; Marwa Al-Azzawi; Roshneen Ali; Giles Bond-Smith; Ben Colleypriest; Sarah Dyer; Benjamin Masterman; Michael Okocha; Alan Osborne; Rikhilroy Patel; Mahmoud Sallam; Emmanuel Selveraj; Samar Shalaby; Wenrui Sun; Fraser Todd; Joel Ward; Rebecca Windle; Saboor Khan; Nigel Williams; Ramesh P Arasaradnam Journal: World J Surg Date: 2021-05-12 Impact factor: 3.352
Authors: P R de Reuver; A H van Dijk; S Z Wennmacker; M P Lamberts; D Boerma; B L den Oudsten; M G W Dijkgraaf; S C Donkervoort; J A Roukema; G P Westert; J P H Drenth; C J H van Laarhoven; M A Boermeester Journal: BMC Surg Date: 2016-07-13 Impact factor: 2.102