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Post-cholecystectomy syndrome in pediatric patients: Occurrence and spectrum of symptoms
Martin Treider1, Susanne Ohnesorge1, Kristin Bjørnland2
1Oslo University Hospital, Mailbox 4950, Nydalen, Oslo 0424, Norway.
Insights
Post-cholecystectomy syndrome (PCS) is common in children, with diarrhea and bloating as frequent symptoms. Overweight may increase PCS risk, but most children are satisfied after gallbladder removal.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Outcomes
Background:
- Post-cholecystectomy syndrome (PCS) is characterized by persistent or new abdominal symptoms following gallbladder removal.
- Limited data exists on PCS prevalence and symptomology in pediatric populations.
Purpose of the Study:
- To determine the frequency of PCS in pediatric patients post-cholecystectomy.
- To identify common symptoms experienced by affected children.
- To explore potential risk factors associated with PCS in this demographic.
Main Methods:
- Retrospective cross-sectional study of pediatric patients undergoing cholecystectomy between 2003-2019.
- Utilized PedsQL™ gastrointestinal symptoms scale and a custom questionnaire for data collection.
- Obtained patient/parental consent and ethical approval.
Main Results:
- Of 82 patients surveyed, 44 (54%) responded. 16 (36.7%) patients were diagnosed with PCS.
- Most common PCS symptoms included diarrhea (25%), bloating (16%), and heartburn/reflux (16%).
- Overweight patients had a higher incidence of PCS (31% vs. 4%, p=0.014). Patient satisfaction was lower in PCS group (56.6% vs. 92.6%, p=0.012).
Conclusions:
- PCS is a significant finding in pediatric patients after cholecystectomy, presenting with diverse gastrointestinal issues.
- Overweight identified as a potential risk factor for PCS development in children.
- Despite PCS, a majority of pediatric patients reported satisfaction with the cholecystectomy outcome.
Background:
Post-cholecystectomy syndrome (PCS) refers to persistent or new abdominal symptoms after cholecystectomy. As there are very few reports on PCS in pediatric patients, we aimed to examine whether it was a frequent finding and which symptoms the affected children experienced.
Method:
This is a retrospective cross sectional study of pediatric patients, who underwent cholecystectomy during 2003-2019 at Oslo University Hospital. The PedsQL™ gastrointestinal symptoms scale questionnaire and a self-designed questionnaire exploring satisfaction after surgery and current medical conditions were mailed to all eligible patients. Patient/parental consent and approval from the local data protection officer (19/09054) were obtained.
Results:
Questionnaires were sent to 82 patients of whom 44 (54%) answered. There were no significant demographic differences between the responders and the non responders. We identified 16 (36.7%) patients to have PCS. The most common symptoms were diarrhea (25%), bloating (16%), and heartburn/reflux (16%). Overweight was more common in patients with PCS (31%) than in patients without PCS (4%) (p = 0.014). Altogether 34/44 (77.3%) patients were satisfied with the result of the cholecystectomy; 92,6% of patients without PCS and 56.6% of those with PCS (p = 0.012).
Conclusion:
PCS is not uncommon in pediatric patients, and they report a wide range of gastrointestinal symptoms. We identified overweight as a potential risk factor for developing PCS. Nonetheless, most patients got total relief of abdominal pain and were satisfied with outcome after cholecystectomy.
Level Of Evidence:
Level 3.
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