Effect of Laparoscopic Cholecystectomy in Alleviating Dyspeptic Symptoms in Patients with Cholelithiasis
Author(s): Mohit S Gupta, Srivastava KN, Mohit Jain, Ajay Chauhan
Objective: To compare the change in preoperative and postoperative dyspeptic symptoms.
Introduction: In the era of increasing prevalence of gall stones due to more frequent incidental detection radiologically, it is the need of the hour that we assess the benefit of these increasing cholecystectomies with regard to dyspeptic symptoms. Till now there is not enough evidence on the basis of which we can determine whether laparoscopic cholecystectomy can resolve the dyspeptic symptoms in patients of gall stones. There is a need to establish a guideline to operate in view of alleviating dyspeptic symptoms.
Methodology: A total of 308 (M:F=2:3) patients were evaluated for dyspeptic symptoms using the Glasgow dyspepsia severity score (GDSS). They were followed up after 1 month, 6 months. Disease distribution and change in GDSS scores were analysed.
Results: The mean age was 47.2 ± 15.42 years. Preoperatively mean GDSS was 11.49 ± 2.11. One month post surgery 82% had a GDSS around 2.95. 12% had a significant drop in GDSS at the end of 6 months (p<0.001). 3.89% had a GDSS of more than 10 which indicated persistentdyspepsia. 3 patients 0.97% had subsequent worsening of GDSS.
Conclusion: Most symptomatic patients undergoing laparoscopic cholecystectomy are objectively relieved of dyspeptic symptoms. Very few patients have persistent symptoms even after 6 months. Patients tend to associate relief of dyspepsia with successful outcome of surgery. It is extremely essential that patients be counselled in detail about the possibility of persistence of dyspeptic symptoms which may in-fact be functional/inorganic.