Document Detail


Abdominal symptoms: do they disappear after cholecystectomy?
MedLine Citation:
PMID:  12802649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effect of cholecystectomy in patients with gallstones on preoperative abdominal symptoms. METHODS: A systematic search was made of the Medline database in combination with reference checking. Articles were excluded if patients aged <18 years, symptom relief rates could not be calculated, if follow-up after cholecystectomy was less than 1 month, or when the included patients were at extraordinary risk for a complicated outcome. Potential differences in relief rates due to patient selection, retrospective versus prospective design, duration of follow-up, or intervention were analyzed using logistic regression. RESULTS: The pooled relief rate for "biliary pain" was high 92% (95% confidence interval 86 to 96%). Symptom relief rates were consistently higher in studies that included acute cholecystectomies. For upper abdominal pain--without restrictions for intensity or duration--pooled relief rates ranged from 72% (66 to 77%) after elective cholecystectomy, to 86% (83 to 91%) after acute cholecystectomy. The relief rate of food intolerance was higher in studies with a follow-up < or =12 months (88%, 76 to 91%) compared to studies with a follow-up of more than 12 months (65%, 55 to 74%). CONCLUSION: In almost all patients with gallstones biliary pain disappeared after cholecystectomy. There is insufficient evidence, however, that this relief was due to cholecystectomy. Relief rates of other isolated symptoms were low in patients with an elective cholecystectomy. A proper evaluation of the effectiveness of cholecystectomy in terms of abdominal symptom relief rates requires a randomized trial.
Authors:
M Y Berger; T C Olde Hartman; A M Bohnen
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Publication Detail:
Type:  Journal Article; Meta-Analysis     Date:  2003-06-17
Journal Detail:
Title:  Surgical endoscopy     Volume:  17     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2004-01-14     Completed Date:  2004-04-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1723-8     Citation Subset:  IM    
Affiliation:
Department of General Practice, Erasmus MC, Rotterdam, The Netherlands. m.berger@erasmusmc.nl
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / epidemiology*,  etiology
Adult
Bias (Epidemiology)
Biliary Tract Diseases / epidemiology,  etiology
Cholecystectomy*
Cholelithiasis / complications,  surgery
Colic / epidemiology,  etiology
Dyspepsia / epidemiology*,  etiology
Follow-Up Studies
Humans
Patient Dropouts
Patient Selection
Postoperative Period
Prospective Studies
Research Design
Retrospective Studies
Surgical Procedures, Elective
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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