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A long-term cohort study of outcome after cholecystectomy for chronic acalculous cholecystitis
Sanjay B Jagannath1, Vikesh K Singh, Marcia Cruz-Correa
1Division of Gastroenterology, The Johns Hopkins Hospital, Room 419, 1830 E. Monument St., Baltimore, MD 21205, USA.
Insights
Cholecystectomy effectively treats chronic calculous cholecystitis (CCC) and chronic acalculous cholecystitis (CAC). Patients with CAC experience long-term pain relief comparable to those with CCC after surgery.
Area of Science:
- Gastroenterology
- Surgical Outcomes
Background:
- Cholecystectomy is a standard treatment for chronic calculous cholecystitis (CCC).
- The long-term efficacy of cholecystectomy for chronic acalculous cholecystitis (CAC) remains unclear.
Purpose of the Study:
- To evaluate the long-term outcomes of cholecystectomy in patients with CAC compared to CCC.
- To assess the resolution of biliary pain in post-cholecystectomy patients with and without gallstones.
Main Methods:
- A retrospective cohort study compared patients with CAC and matched controls with CCC.
- Biliary pain was assessed preoperatively and during long-term follow-up (average 8.37 years).
Main Results:
- Patients with CAC had longer pre-operative symptom duration (38.3 months) than CCC patients (8.1 months).
- Both CAC and CCC groups showed significant benefit from cholecystectomy (P <0.001).
- Long-term pain-free rates were similar: 95% for CAC and 84% for CCC (P >0.05).
Conclusions:
- Cholecystectomy provides similar long-term pain resolution for patients with CAC and CCC.
- Patients with chronic cholecystitis, regardless of gallstones, achieve complete pain relief post-surgery.
Background:
Cholecystectomy is effective therapy for chronic calculous cholecystitis (CCC). The long-term outcome of patients treated with cholecystectomy for chronic acalculous cholecystitis (CAC) is unknown.
Methods:
A controlled, retrospective cohort study assessing biliary pain (preoperative and at follow-up) in postcholecystectomy patients with CAC or CCC was performed.
Results:
In 19 CAC and with matched CCC control patients, the mean duration of symptoms before surgery was 38.3 months (95% CI, 16.4 to 60.2) and 8.1 months (95% CI, 5.4 to 10.8), respectively. The mean follow-up for both groups was 8.37 +/- 1.13 years. Both groups benefited from cholecystectomy (P <0.001), and both were equally likely to be pain-free upon long-term follow-up (95% CAC versus 84% CCC, P >0.05).
Conclusions:
There was no difference in outcome between the groups after an average follow-up of 8.37 years. Postcholecystectomy patients with chronic cholecystitis and no gallstones have long-term, complete pain resolution, similar to patients with gallstones.
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Assessment: