Postcholecystectomy Syndrome: From Pathophysiology to Differential Diagnosis - A Critical Review

Postcholecystectomy syndrome (PCS) is persistent distressing symptoms which develops following a laparoscopic cholecystectomy (LC); in cases when the condition is severe, readmission may be necessary. However, research on the prevalence of PCS and potential factors associated with PCS in Nepalese patients is still limited. An observational point-prevalence, correlational predictive cross-sectional study was conducted to determine the prevalence of PCS and examine what predicting factors including preoperative anxiety, preoperative dyspepsia, smoking, alcohol consumption, and duration of preoperative symptoms are associated with PCS. A total of 127 eligible Nepalese patients who came for follow-up after 1 week of LC at outpatient department of surgery in one single university hospital, Kathmandu, Nepal, were recruited. A set of questionnaires consisting participants' information record form, Hospital Anxiety and Depression Scale (HADS), Leeds Dyspepsia Questionnaires (LDQ), Fagerstrom Test for Nicotine Dependence (FTND), and Alcohol Use Disorder Identification Test (AUDIT) was administered for data collection. The associations between influential factors and PCS were analyzed using Binary logistic regression. 43.3% of participants reported PCS after 1 week of surgery. The findings from logistic regression analysis affirmed that the patients with preoperative anxiety (OR = 6.38, 95%CI = 2.07–19.67, p < 0.01) and moderate to severe dyspepsia (OR = 4.01, 95%CI = 1.34–12.02, p < 0.05) held the likelihood to report PCS 6.38 and 4.01 times, respectively, greater than others. The implications from study results are that screening of anxiety and patients’ tailored interventions to reduce anxiety should be implemented preoperatively. An appropriate health education about persistence of PCS and self-management should be provided to those postoperative patients.

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Postcholecystectomy syndrome: a new look at the old problem and the possibilities of pathogenetic therapy.

Zvyagintseva¹,

Chernobay²,

Yaroshenko³

et al. 2023

Shidnoevr. z. vnutr. simejnoi med.

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In the article, from the modern standpoint, the pathogenetic and clinical characteristics of PCS as a dysfunction of the sphincter of Oddi are given, the mechanisms for the development of this pathology, the principles of therapy with the inclusion of the drug Rowachol, containing six plant monoterpenes, are disclosed. The materials of our own observations of the treatment of patients with Oddi sphincter dysfunction after laparoscopic cholecystectomy by Rowachol are presented. Anti-inflammatory, litholytic, hypocholesterolemic and pleiotropic effects of Rowachol have been proved. Rowachol should be positioned as a pathogenetic natural remedy for treatment of Oddi sphincter dysfunction and biliary sludge in patients undergoing cholecystectomy for cholelithiasis.

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Postcholecystectomy Syndrome: From Pathophysiology to Differential Diagnosis - A Critical Review

Abstract: PCS may be caused by organic or functional diseases of the gastrointestinal tract. It can be further classified into two groups for systematic evaluation. Patients with symptoms of non-biliary tract origin and those with symptoms of biliary tract origin. If organic

Cited by 5 publications

References 54 publications

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Prevalence and predictors of postcholecystectomy syndrome in Nepalese patients after 1 week of laparoscopic cholecystectomy: a cross-sectional study

Postcholecystectomy syndrome: a new look at the old problem and the possibilities of pathogenetic therapy.

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