High Incidence of Postcholecystectomy syndrome: Can We Reduce It?

摘要

The incidence of postcholecystectomy syndrome (PCS) at Cipto Mangunkusumo Hospital, Indonesia, was previously found to be 54.29% (2012), which was higher than those reported in other countries. This research was undertaken to identify the risk factors for PCS in developing countries with limited resources and facilities. This was a cross-sectional study of all patients who underwent cholecystectomy in our hospital during 2015. The variables included sex, body mass index, preoperative symptom duration, preoperative flatulence, level of education, preoperative symptoms, preoperative awareness, and preoperative ultrasound. All the data were analyzed through bivariate and multivariate analyses. In total, 112 patients who underwent laparoscopic cholecystectomy were followed. We found the incidence of PCS to be 45.5%. Multivariate logistic regression analysis showed that preoperative flatulence (P ≤ 0.001, OR = 17.152), nonspecific preoperative symptoms (P = 0.012, OR = 3.984), and patients’ poor preoperative awareness of PCS (P = 0.003, OR = 5.907) were independent predictive factors for PCS. Statistically significant correlation between patients’ awareness and preoperative education (P ≤ 0.001, OR = 69.00) was found. We concluded that preoperative flatulence, nonspecific preoperative symptoms, and poor preoperative awareness increased the incidence of PCS. Besides abdominal ultrasound, other examinations, such as upper GI endoscopy, for nonspecific preoperative symptoms that do not meet the Rome III criteria are recommended to rule out the diagnosis and avoid unnecessary surgeries. Adequate preoperative information and education may reduce the incidence of PCS.