The Predictive Value of Pre-Operative Symptoms
M. C. Mertens & J. De Vries & V. P. W. Scholtes &
P. Jansen & J. A. Roukema
Objective Many patients with symptomatic cholelithiasis report persisting symptoms after elective cholecystectomy. The current prospective follow-up study aims at the identification and valuation of risk factors for negative symptomatic outcome at 6 weeks.
Methods Consecutive patients (n=183), age 18–65 years, indicated for elective cholecystectomy due to symptomatic cholelithiasis, completed a self-report questionnaire. At 6 weeks post-operatively, the same self-report questionnaires were completed (n=129). Predictors of the persistence and emergence of biliary and dyspeptic symptoms at 6 weeks postcholecystectomy were investigated using univariate and multivariate logistic regression. Results At 6 weeks post-operatively, the report of post-operative biliary symptoms was independently predicted by preoperative dyspeptic symptoms (OR=6.60) and bad taste (OR=3.55). Pre-operative flatulence was an independent predictor of the report of biliary and dyspeptic symptoms ((OR=3.33) and (OR=3.27), respectively) and persisting biliary symptoms (OR=4.21). Predictors of symptomatic outcome were only identified in women, not in men.
Conclusion Patients with pre-operative dyspeptic symptoms, notably bad taste and flatulence, have an increased risk of negative post-cholecystectomy outcomes at 6 weeks. A symptom-specific approach should lead to optimalization of the indication of cholecystectomy and information of patients. Known risk factors for long-term outcomes might be valuable in female patients only.
Keywords Cholecystectomy. Prediction . Symptoms
Source : https://pure.uvt.nl/ws/files/1050268/Prospective.pdf