A PROSPECTIVE STUDY OF PREDICTORS AND CAUSES OF POSTCHOLECYSTECTOMY PAIN
Dowidar, N., Anwar, M., Awad, E., Abou Raya, F., Mekky, F. (2004). A PROSPECTIVE STUDY OF PREDICTORS AND CAUSES OF POSTCHOLECYSTECTOMY PAIN. EKB Journal Management System, 23(3), 250-257. doi: 10.21608/ejsur.2004.373745
N. Dowidar; M. Anwar; E. Awad; F. Abou Raya; F. Mekky. "A PROSPECTIVE STUDY OF PREDICTORS AND CAUSES OF POSTCHOLECYSTECTOMY PAIN". EKB Journal Management System, 23, 3, 2004, 250-257. doi: 10.21608/ejsur.2004.373745
Dowidar, N., Anwar, M., Awad, E., Abou Raya, F., Mekky, F. (2004). 'A PROSPECTIVE STUDY OF PREDICTORS AND CAUSES OF POSTCHOLECYSTECTOMY PAIN', EKB Journal Management System, 23(3), pp. 250-257. doi: 10.21608/ejsur.2004.373745
Dowidar, N., Anwar, M., Awad, E., Abou Raya, F., Mekky, F. A PROSPECTIVE STUDY OF PREDICTORS AND CAUSES OF POSTCHOLECYSTECTOMY PAIN. EKB Journal Management System, 2004; 23(3): 250-257. doi: 10.21608/ejsur.2004.373745

A PROSPECTIVE STUDY OF PREDICTORS AND CAUSES OF POSTCHOLECYSTECTOMY PAIN

The Egyptian Journal of Surgery
Volume 23, Issue 3, July 2004, Page 250-257  XML PDF (152.64 K)
Document Type: Original Article
DOI: 10.21608/ejsur.2004.373745
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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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