Symptomatic improvement post cholecystectomy at two year mark –
At two years ONLY (53%) were completely symptom free. Postcholecystectomy symptoms occurring in the remaining 47% patients, mainly :
– flatulent dyspepsia
– dull abdominal pain
– or diarrhoea
“nearly one half of operated patients are dissatisfied with the procedure because of mild but distressing ‘postcholecystectomy’ symptoms” 
And Open verse Laparoscopic Cholecystectomy
‘Patients who underwent laparoscopic cholecystectomy tended to have a higher incidence of nausea or vomiting than those undergoing the open procedure, and consumed significantly more antacids’
‘There was no difference in the number of patients who considered the operation to have cured or improved their preoperative symptoms after laparoscopic cholecystectomy or open cholecystectomy’ 
“While most symptoms improve, a significant number of pain and nonpain symptoms persist after laparoscopic cholecystectomy” 
“After LC, 17% of patients reported troublesome new-onset diarrhoea. PCD was independently associated with younger age, especially <50, and postoperative food intolerance” 
Postcholecystectomy symptoms. A prospective study of gall stone patients before and two years after surgery(Review)
- Gastroenterology Service, Hospital Clinic i Provincial, Faculty of Medicine, C/ Villarroel. 170, 08036 Barcelona, Spain
The results of cholecystectomy in terms of symptomatic improvement were prospectively evaluated in 124 unselected gall stone patients interviewed before and two years after elective surgery. Indications for cholecystectomy were biliary pain (n=65), previous complications of gall stone disease (n=52), and flatulent dyspepsia (n=7). At two years 93 patients could be re-evaluated, of whom only 49 (53%) were completely symptom free. Postcholecystectomy symptoms occurring in the remaining 44 patients were mainly flatulent dyspepsia (which had relapsed in 22 of 46 patients who suffered it preoperatively), dull abdominal pain or diarrhoea. Incisional hernia was present in five patients and one had recurrence of pain because of retained common bile duct stones. Symptomatic cures after cholecystectomy decreased with the duration of the preoperative history. The results reconfirm that cholecystectomy eradicates specific symptoms and complications of gall stone disease, but they also show that nearly one half of operated patients are dissatisfied with the procedure because of mild but distressing ‘postcholecystectomy’ symptoms. These are probably caused by previously undiagnosed functional gut disease associated with, but unrelated to, gall stones. A systemic approach to multisymptomatic patients with gall stones is recommended.
Symptomatic outcome after laparoscopic cholecystectomy(Article)
- Department of Surgery, Western General Hospital, Alexander Donald Building, Edinburgh, EH4 2XU, United Kingdom
To evaluate the symptomatic outcome after laparoscopic cholecystectomy, a standard symptom questionnaire was sent to three patient groups at least 1 year after surgery: 115 patients had undergone laparoscopic cholecystectomy; 200 had undergone open cholecystectomy; and 200 had had inguinal hernia repair. Return of questionnaires was higher after laparoscopic cholecystectomy (100 of 115; 87.0 per cent) than the open procedure (167 of 200; 83.5 per cent) or hernia repair (163 of 200; 81.5 per cent). There was no difference in the number of patients who considered the operation to have cured or improved their preoperative symptoms after laparoscopic cholecystectomy (94 of 100; 94.0 per cent), open cholecystectomy (157 of 167; 94.0 per cent) or hernia repair (154 of 163; 94.5 per cent). Similar numbers considered their operation to have been a success (94.0, 95.2 and 94.5 per cent respectively). The prevalence of abdominal pain, nausea, flatulence, food intolerance and heartburn was similar in all groups of patients following operation. Diarrhoea occurred more often following laparoscopic (6.0 per cent) and open (4.2 per cent) cholecystectomy than hernia repair (1.2 per cent). Patients who underwent laparoscopic cholecystectomy tended to have a higher incidence of nausea or vomiting than those undergoing the open procedure, and consumed significantly more antacids (23.0 versus 12.0 per cent, P < 0.02). Laparoscopic cholecystectomy achieved the same rate of patient satisfaction as open cholecystectomy, with no apparent symptomatic advantage. Copyright © 1993 British Journal of Surgery Society Ltd.
Symptoms before and after laparoscopic cholecystectomy for gallstones(Conference Paper)
- aDepartment of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- b8635 West Third Street, #795 W, Los Angeles, CA 90048, United States
Between 1989 and 1995, 1380 patients underwent laparoscopic cholecystectomy for symptomatic cholelithiasis by a single surgical group at a large private teaching hospital. Thirteen hundred surveys were mailed, and 573 (44.3%) were completed at least 6 months postoperatively. Pain and nonpain symptoms were present preoperatively in 432 (75%) and 457 (80%) patients, respectively. Postoperatively, pain and nonpain symptoms were present in 141 (25%) and 247 (43%) patients, respectively (P < 0.05). All nonpain symptoms were significantly reduced postoperatively except for diarrhea (P < 0.05). Longer duration of pain, age < 40, frequent episodes of pain, postprandial pain, and increased sites of pain preoperatively were all predictive of a higher incidence of persistent postoperative pain (P < 0.05). Persistent nonpain symptoms were more likely if diarrhea, fatty food intolerance, age < 40, or both pain and nonpain symptoms were present preoperatively (P = 0.05) and less likely if only pain symptoms were present preoperatively (P = 0.0001). This series quantifies symptom-specific outcomes for the surgeon. While most symptoms improve, a significant number of pain and nonpain symptoms persist after laparoscopic cholecystectomy. With these data, surgeons can modulate postoperative expectations and advise on the possible persistence of symptoms.