Original article—liver, pancreas, and biliary tractFactors That Predict Relief From Upper Abdominal Pain After Cholecystectomy
Section snippets
Study Sites and Subject Selection
We conducted the study at Mayo Clinic Rochester (MCR), a tertiary referral center, and the Kaiser Permanente Medical Care Plan in San Diego (KPSD), a prepaid integrated system serving about 500,000 people. KPSD and MCR research assistants considered for participation all cholecystectomy patients at least 18 years of age from June 2000 to February 2003 by review of elective surgical schedules as well as review of all laboratory histology reports to detect other patients, such as those who had
Baseline Data
As shown in Table 1, the age of MCR and KPSD patients was similar, but there was a higher proportion of females at KPSD. MCR patients were almost all Caucasian, whereas KPSD patients generally reflected the more diverse racial/ethnic distribution of San Diego County. In addition, site (MCR vs KPSD) was associated with severity of the worst pain (higher in KPSD subjects than in MCR subjects, 8.3 ± 2.0 vs 7.8 ± 2.3; P = .001). Overall, the patients rated their worst pain as 8.1 ± 2.1, and 877
Discussion
In this prospective study of patients with UAP undergoing elective cholecystectomy for uncomplicated gallstone disease, we identified features of UAP that were more common in patients who reported relief both 3 and 12 months postoperatively and other symptoms that predicted no persistent relief. When 4 features positively associated with UAP relief were combined, the odds for relief increased progressively with an increasing number of features. Coexisting GERD, IBS, or somatization adversely
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Usefulness of endoscopic ultrasound in patients with minilithiasis and/or biliary sludge as a cause of symptoms of probable biliary origin after cholecystectomy
2022, Gastroenterologia y HepatologiaCitation Excerpt :In our study, we found that a typical clinical picture of biliary colic in patients diagnosed with minilithiasis-sludge by EUS was associated with clinical remission after cholecystectomy in 86% of the cases. These results are even better than those obtained in patients diagnosed with symptomatic cholelithiasis by abdominal ultrasound (60–70%), and, therefore, lend support to cholecystectomy in patients with typical symptoms and minilithiasis-biliary sludge diagnosed by EUS.1–4,23 The greater remission of the symptomatology observed in our study is probably due to the fact that our patients were selected due to high clinical suspicion, and it also supports the idea that accurate clinical assessment is very important prior to performing such an examination.
Pancreaticobiliary Pain and Suspected Sphincter of Oddi Dysfunction
2018, ERCP, Third EditionFactors relevant to persistent upper abdominal pain after cholecystectomy
2017, HPBCitation Excerpt :Therefore, it is important to investigate the causes of persistent UAP following cholecystectomy. Several previous studies have identified certain preoperative factors predicting UAP relief following cholecystectomy, e.g. UAP frequency, duration, nocturnal pattern, and some concomitant morbidity, etc.15–18 Therefore, it is recommended that determining preoperatively whether the gallstones are the cause of upper abdominal symptoms or merely an incidental finding are critical for avoiding unnecessary cholecystectomy and persistent symptoms after surgery.9,10 However, what exactly constitutes biliary-like abdominal pain and associated symptoms still remains unclear.
Chapter 13 - Clinical investigation of hepatopancreatobiliary disease
2017, Blumgart's Surgery of the Liver, Biliary Tract and Pancreas: Sixth EditionEffects of Rowachol on prevention of postcholecystectomy pain after laparoscopic cholecystectomy: prospective multicenter randomized controlled trial
2016, HPBCitation Excerpt :Other symptom scales, excepting PCP on EORTC QLQ C-30 questionnaire and functional scales, were not statistically significantly different between groups (Table 6). LC is a very effective treatment for GB disease, but PCP is not uncommon.3,8–11,28 Approximately 30–50% of patients who undergo cholecystectomy remain symptomatic, where the management of PCP can be quite challenging.1,6–9,28,29
EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones
2016, Journal of Hepatology
Conflicts of interest The authors disclose no conflicts.
Funding This work was supported by Morton and Estelle Sosland Fund and Mayo Foundation.