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Factors relevant to persistent upper abdominal pain after cholecystectomy
Jing Zhang1, Qiang Lu1, Yi-Fan Ren1
1Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Shaanxi Province, 710061, China; Shaanxi Provincial Regenerative Medicine and Surgical Engineering Research Center Xi'an, Shaanxi Province, 710061, China.
Female patients with longer and more frequent upper abdominal pain (UAP) before surgery are more likely to experience persistent UAP after cholecystectomy. Choleretic medications can help relieve this postoperative pain.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Abdominal Pain Management
Background:
- Cholecystectomy is a common surgical procedure for gallstone-related upper abdominal pain (UAP).
- Persistent UAP post-cholecystectomy affects a significant minority of patients.
- Identifying risk factors for persistent UAP is crucial for improving patient outcomes.
Purpose of the Study:
- To identify risk factors associated with persistent upper abdominal pain (UAP) after cholecystectomy.
- To explore factors contributing to sustained relief of UAP following the procedure.
Main Methods:
- A cohort of 1714 symptomatic patients undergoing cholecystectomy for gallstones was enrolled.
- Patients completed a biliary symptom questionnaire preoperatively and postoperatively.
- Multivariate analysis was used to evaluate risk factors for persistent UAP and factors related to pain relief.
Main Results:
- 10% of patients (172/1714) experienced persistent UAP post-cholecystectomy.
- Independent risk factors for persistent UAP included female gender, preoperative UAP >24h duration, and episodes >30min.
- Sustained UAP relief (76.7%) was associated with shorter preoperative UAP duration, less frequent episodes, and choleretic medication use.
Conclusions:
- Female gender and a history of longer, more frequent preoperative UAP are significant predictors of persistent post-cholecystectomy pain.
- Choleretic medications demonstrate efficacy in alleviating postoperative upper abdominal pain.
- Understanding these factors can guide patient selection and postoperative management strategies.
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