A PROSPECTIVE STUDY OF PREDICTORS AND CAUSES OF POSTCHOLECYSTECTOMY PAIN | ||
| The Egyptian Journal of Surgery | ||
| Volume 23, Issue 3, July 2004, Pages 250-257 PDF (152.64 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2004.373745 | ||
| Authors | ||
| N. Dowidar* 1; M. Anwar1; E. Awad1; F. Abou Raya1; F. Mekky2 | ||
| 1Department of Experimental and Clinical Surgery, Medical Research Institute | ||
| 2Department of Surgery, Faculty of Medicine, University of Alexandria | ||
| Abstract | ||
| Aim: A proportion of patients complain of pain after cholecystectomy. The aim of this study was to prospectively identify clinical predictors and causes of post-cholecystectomy pain. Methods: Forty patients with symptomatic gallstones were interviewed to assess their pain and associated symptoms before and 6 months after cholecystectomy. Patients who suffered from pain (Visual analogue scale - VAS ≥ 4) after cholecystectomy had an ERCP performed with sphincter of Oddi (SO) manometry study. Results: Nine patients (22.5%) suffered from pain after cholecystectomy. Univariate and multivariate logistic regression identified vomiting as the only independent predictor of post-cholecystectomy pain. Two patients refused further treatment. During ERCP and SO motility study a bile duct stone was detected and extracted in one patient. SO manometry was performed to the other six patients. Abnormal SO motility was found in five patients and a classical sphincterotomy was performed to all patients. After a median of 10 (6-18) months follow-up patients were satisfied with the results of sphincterotomy as their VAS decreased from a mean ± SD of 7.0 ± 2.2 to 1.8 ± 0.43. Conclusion: Cholecystectomy rids patients of their gallstones but not necessarily their pain. SO dysfunction is the cause in the majority of patients with post-cholecystectomy pain. | ||
| Keywords | ||
| sphincter of Oddi; manometry; sphincterotomy | ||
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