Ma. Qureshi et al., POSTCHOLECYSTECTOMY SYMPTOMS AFTER LAPAROSCOPIC CHOLECYSTECTOMY, Annals of the Royal College of Surgeons of England, 75(5), 1993, pp. 349-353
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.