Laparoscopic cholecystectomy and the dyspeptic patient : identifying the appropriateness of operative intervention
Malik, Dr. Samaad
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The purpose of this study is to determine if early laparoscopic cholecystectomy in patients with uncomplicated gallstone disease and symptoms of dyspepsia will produce complete symptomatic resolution 1 year postoperatively and to identify appropriate timing of laparoscopic cholecystectomy to decrease cholecystectomy failure rate. Specific research objectives were to determine: 1) if laparoscopic cholecystectomy in patients with gallstones and symptoms of dyspepsia will achieve complete symptomatic relief; 2) the change in the preoperative score to the postoperative score and satisfaction after laparoscopic cholecystectomy for the two groups: patients with gallstones and symptoms of dyspepsia and the patients with gallstones and no dyspepsia; 3) the relationship between the duration of preoperative episodes and the probability of complete resolution of symptoms with laparoscopic cholecystectomy in patients with gallstones and symptoms of dyspepsia; 4) the relationship between the frequency of preoperative episodes and the probability of complete resolution of symptoms with early laparoscopic cholecystectomy in patients with gallstones and symptoms of dyspepsia and 5) the differences in pathologic findings between patients with gallstones and no symptoms of dyspepsia versus patients with symptoms of dyspepsia.The methods included a retrospective chart review for patient identification, a follow up survey and microscopic pathological examination of gallbladder specimens. Nine hundred and forty two patients entered the study. Three hundred and fifty nine surveys were returned producing a response rate of 43%. Two hundred and sixty four patients (77.0%) had symptoms of dyspepsia (Group I) and 79 patients (23.0%) had no symptoms of dyspepsia (Group II). Laparoscopic cholecystectomy for patients with gallstones and symptoms of dyspepsia does not achieve complete symptomatic relief 1 year after surgery. The frequency and duration of preoperative episodes have no relation to the outcome of surgery. The majority of patients in both Groups (I, II) were found to have morphological evidence of acute cholecystitis and only a small number had chronic cholecystitis. Group I had a greater reduction in the Buckley score than Group II after LC but had similar rates of satisfaction from surgery.
DegreeMaster of Science (M.Sc.)
SupervisorKeith, Roger G.
CommitteeReeder, Bruce; McFadden, Andrew; Chibbar, Rajni; Seshadri, Pieter
Copyright DateApril 2007