WHAT SYMPTOMS DOES CHOLECYSTECTOMY CURE - INSIGHTS FROM AN OUTCOMES MEASUREMENT PROJECT AND REVIEW OF THE LITERATURE

BACKGROUND: The increasing application of cholecystectomy has increased the need to assess the effects of cholecystectomy on presenting symptoms. PATIENTS AND METHODS: Three surgeon-derived and two patient-derived data forms were collected for each patient in a series of 225 laparoscopic cholecystectomies. RESULTS: Eighty-two percent of patients had documented gallstones preoperatively, 91% had biliary pain, and 77% had both biliary pain and documented gallstones prior to surgery. Fifteen percent of patients were believed to have acalculous cholecystitis. Eighty-two percent also had bothersome nonpain symptoms (gassiness, bloating, indigestion, fatty-food intolerance, and nausea). The cure rate for biliary colic was 82% if stones were documented preoperatively, and 52% when they were not (P = 0.002). Atypical pain was cured 80% of the time, and nonpain symptoms, 44% of the time. CONCLUSIONS: Most patients (82%) with biliary colic and gallstones have complete relief of upper abdominal pain after cholecystectomy. Pain relief in patients felt to have acalculous cholecystitis was only 52%. Nonpain symptoms were common preoperatively (82%) and were relieved in 44% of patients.