| Risk assessment in cholelithiasis: is cholecystectomy always to be preferred? | |
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MedLine Citation:
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PMID: 20502977 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: As many patients with gallstone disease do not benefit from cholecystectomy, preoperative recognition of such high-risk patients is important. The aim of the study is to identify predictors of persisting symptoms at 6 months after cholecystectomy for patients with different preoperative symptomatology. METHOD: Participants in this prospective study were consecutive patients (n = 172), age 18-65 years, with symptomatic cholelithiasis, undergoing a laparoscopic cholecystectomy. Predictors were identified using uni- and multivariate regression analyses. RESULTS: At 6 months postcholecystectomy, patients with only preoperative biliary symptoms were most often free of symptoms (62.5%). Patients with only dyspeptic symptoms most often reported persistence of preexisting symptoms (63.2%). Preoperative non-specific symptoms predicted the report of postoperative biliary and/or dyspeptic symptoms (OR = 4.5-6.1). Persistence of preexisting pattern of symptoms was predicted by the use of psychotropic medication (OR = 5.3) and dyspeptic symptoms (OR = 4.5). Postoperative biliary symptoms were predicted by High Trait Anxiety (HTA) (OR = 10.6). CONCLUSION: Surgeons should take account of individual risks of patients in the management of cholelithiasis. Instead of cholecystectomy, expectative management should be the first choice in patients with non-specific symptoms, with dyspeptic symptoms only, with HTA and in patients using psychotropic medication. |
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Authors:
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Marlies C Mertens; Jan A Roukema; Vincent P W Scholtes; Jolanda De Vries |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-05-26 |
Journal Detail:
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Title: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Volume: 14 ISSN: 1873-4626 ISO Abbreviation: J. Gastrointest. Surg. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-26 Completed Date: 2010-11-09 Revised Date: 2013-05-29 |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1271-9 Citation Subset: IM |
Affiliation:
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CoRPS-Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, 5000 LE, Tilburg, the Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Cholecystectomy, Laparoscopic / methods* Cholelithiasis / diagnosis, epidemiology, surgery* Female Follow-Up Studies Humans Male Middle Aged Preoperative Care / methods* Prognosis Prospective Studies Questionnaires Risk Assessment* Risk Factors Severity of Illness Index Young Adult |
| Comments/Corrections | |
Comment In:
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J Gastrointest Surg. 2012 May;16(5):1078-9
[PMID:
22328002
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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