Document Detail


Risk assessment in cholelithiasis: is cholecystectomy always to be preferred?
MedLine Citation:
PMID:  20502977     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Marlies C Mertens; Jan A Roukema; Vincent P W Scholtes; Jolanda De Vries
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-05-26
Journal Detail:
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:
Created Date:  2010-07-26     Completed Date:  2010-11-09     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1271-9     Citation Subset:  IM    
Affiliation:
CoRPS-Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, 5000 LE, Tilburg, the Netherlands.
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MeSH Terms
Descriptor/Qualifier:
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:
J Gastrointest Surg. 2012 May;16(5):1078-9   [PMID:  22328002 ]

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


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