POSTCHOLECYSTECTOMY SYMPTOMS AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Abdominal symptoms persist in up to 40% of patients after laparotomy c holecystectomy and biliary lithotripsy. Laparoscopic cholecystectomy i s now the treatment of choice for symptomatic gallstone disease. Howev er, no data exist as to the influence of laparoscopic cholecystectomy on symptoms. We analysed 100 patients who had undergone laparoscopic c holecystectomy at a median of 12 months (range 10-19 months) previousl y. Pre- and postoperative symptoms were compared and patient satisfact ion was graded from 1 (best) to 5 (worst). Time to resumption of full activity (mean +/- SD) was recorded. All patients had more than two sy mptoms preoperatively. Postoperatively, 61 patients had complete absen ce of symptoms, 14 patients complained of only one symptom during the postoperative period and 25 patients continued to have at least two sy mptoms. The mean time taken to return to full activity was 2.4 +/- 1.7 weeks. In patients without any symptoms postoperatively, time taken t o return to full activity was 2.3 +/- 1.5 weeks, 2.7 +/- 1.4 weeks for patients with one symptom postoperatively, while patients with two or more symptoms returned to full activity in 2.3 +/- 1.3 weeks and 2.6 +/- 1.7 weeks, respectively. Notwithstanding that 25% of patients repo rted two or more symptoms postoperatively, most patients (n = 84) cons idered the procedure to be a complete success. A further 10 patients h ad significant improvement after laparoscopic cholecystectomy. Five pa tients considered themselves only slightly improved, while a single pa tient was no better off postoperatively. These data indicate that afte r laparoscopic cholecystectomy most patients return to full activity w ithin 3 weeks. Thus, the incidence of post-cholecystectomy symptoms is similar after laparoscopic and laparotomy cholecystectomy and biliary lithotripsy. Patients should be advised of the risk of persistent sym ptoms after these procedures.