Shankari Suprabha, Maurya Ajeet P, Brahmachari Swagata, Saxena Pradeep, Jagtap Maheshkumar B, Singh Sourabh
General Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Cureus. 2023 Jun 30;15(6):e41171. doi: 10.7759/cureus.41171. eCollection 2023 Jun.
Background Cholecystectomy is one of the most commonly performed surgical procedures, and it is indicated for symptomatic gallstone disease. Symptoms of gallstone disease vary; many patients complain of the persistence of symptoms post-operatively. Hence, it is imperative to know the characteristics of symptoms that predict post-operative resolution. Methodology A prospective cross-sectional study was performed at a tertiary care centre. Patient demography and pre-operative symptoms were noted. Post-operative persistence or relief of symptoms was also documented. The occurrence of any new symptoms was noted. Data were collected at three and six months after surgery. Results Pain was the most common (85%) symptom. The mean frequency of pain was 2.45 per year (range 0-10). The mean duration of pain was 39.7 minutes (range 15-90 minutes). The right hypochondrium (39%) and the epigastric region (42%), along with 8% of patients who experienced pain in both places, were the most frequent locations of pain. The radiation of pain to the right-side scapula is present in 48% of patients. The pain persisted after one-week follow-up in 28 (34%) of patients, 26 (22%) at the end of one month, and 18 (21%) at the end of six months. Dyspepsia was unresolved in 25%, 20%, and 13% of individuals after one week, one month, and six months, respectively. Upper abdominal discomfort was still persistent in 29%, 26%, and 24% of study subjects at the time of follow-up periods, respectively. Similar persistence is found in symptoms of post-prandial fullness and nausea, where unresolved complaints of post-prandial fullness were present in 18%, 13%, and 10% of patients, respectively, and 26%, 14%, and 10% of patients complained of nausea. Conclusion The persistence of symptoms such as upper abdominal discomfort, dyspepsia, post-prandial fullness, and nausea is present, which gradually decreases in severity and presentation over the course of time after the surgical procedure. Some symptoms present after surgery, such as flatulence. Such persistent symptoms might lead to a decreased outcome in terms of patient satisfaction. Patients with atypical pain or dyspepsia need to be counselled pre-operatively regarding the poor resolution of such symptoms.
胆囊切除术是最常施行的外科手术之一，适用于有症状的胆结石疾病。胆结石疾病的症状各不相同；许多患者术后仍有症状。因此，了解预测术后症状缓解的症状特征至关重要。
在一家三级医疗中心进行了一项前瞻性横断面研究。记录患者人口统计学资料和术前症状。还记录术后症状的持续或缓解情况。记录是否出现任何新症状。在术后三个月和六个月收集数据。
疼痛是最常见的症状（85%）。疼痛的平均发作频率为每年2.45次（范围为0 - 10次）。疼痛的平均持续时间为39.7分钟（范围为15 - 90分钟）。最常出现疼痛的部位是右季肋部（39%）和上腹部（42%），8%的患者在这两个部位都有疼痛。48%的患者疼痛向右肩放射。28例（34%）患者在术后一周随访时疼痛仍持续，26例（22%）在术后一个月末仍疼痛，18例（21%）在术后六个月末仍疼痛。消化不良在术后一周、一个月和六个月时分别有25%、20%和13%的患者未缓解。上腹部不适在随访时分别仍有29%、26%和24%的研究对象存在。餐后饱胀和恶心症状也有类似的持续情况，分别有18%、13%和10%的患者餐后饱胀症状未缓解，26%、14%和10%的患者有恶心症状。
上腹部不适、消化不良、餐后饱胀和恶心等症状会持续存在，在手术后一段时间内其严重程度和表现会逐渐减轻。术后会出现一些新症状，如肠胃胀气。这些持续的症状可能会导致患者满意度下降。对于有非典型疼痛或消化不良的患者，术前需要就这些症状缓解不佳的情况进行咨询。
