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Titolo:
Relationship between persistence of abdominal symptoms and successful outcome after cholecystectomy
Autore:
Weinert, CR; Arnett, D; Jacobs, D; Kane, RL;
Indirizzi:
Univ Minnesota, Sch Med, Dept Med, Minneapolis, MN 55455 USA Univ Minnesota Minneapolis MN USA 55455 pt Med, Minneapolis, MN 55455 USA Univ Minnesota, Clin Outcomes Res Ctr, Minneapolis, MN 55455 USA Univ Minnesota Minneapolis MN USA 55455 es Ctr, Minneapolis, MN 55455 USA Univ Minnesota, Sch Publ Hlth, Div Epidemiol, Minneapolis, MN 55455 USA Univ Minnesota Minneapolis MN USA 55455 demiol, Minneapolis, MN 55455 USA Univ Minnesota, Sch Publ Hlth, Div Hlth Serv Res & Policy, Minneapolis, MN55455 USA Univ Minnesota Minneapolis MN USA 55455 Policy, Minneapolis, MN55455 USA
Titolo Testata:
ARCHIVES OF INTERNAL MEDICINE
fascicolo: 7, volume: 160, anno: 2000,
pagine: 989 - 995
SICI:
0003-9926(20000410)160:7<989:RBPOAS>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
LAPAROSCOPIC CHOLECYSTECTOMY; VALIDATION; GALLSTONES; DISEASE; TRIAL; PAIN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Weinert, CR Univ Minnesota, Sch Med, Dept Med, Box 276, Minneapolis, MN 55455 USA Univ Minnesota Box 276 Minneapolis MN USA 55455 , MN 55455 USA
Citazione:
C.R. Weinert et al., "Relationship between persistence of abdominal symptoms and successful outcome after cholecystectomy", ARCH IN MED, 160(7), 2000, pp. 989-995

Abstract

Background: Patients frequently have persistent abdominal symptoms after undergoing cholecystectomy. The relationship between abdominal symptoms and biliary dysfunction is often unclear. Objectives: To describe the persistence rate of abdominal symptoms in a large cohort of patients after elective cholecystectomy, to identify predictors of symptom persistence and operative success, to understand which symptoms improve after cholecystectomy, and to describe the important determinants of an unsuccessful operation. Methods: Secondary analysis of a prospective, multisite cohort study of 2481 patients undergoing elective cholecystectomy. Results: The mean +/- SD number of abdominal symptoms per patient decreased from 3.1 +/- 2.0 to 1.1 +/- 1.3; 27% of patients who identified a symptomas most bothersome before surgery still had the symptom 6 months after surgery. Symptom persistence rates ranged from 5.6% (vomiting) to 40.2% (gas/flatulence). A balance score that quantified the abdominal symptom mix between dyspeptic and biliary symptoms shifted after surgery to the dyspeptic category. Predictors of persistence of a most bothersome symptom were dyspeptic symptom category, worse operative risk and self-rated health status, symptom duration longer than 6 months, and no previous episodes of acute cholecystitis. The major correlate of not achieving a very successful outcome (15.2% of patients) was the presence of postoperative abdominal pain. Other predictors included worse self-rated health status and physical functioning,symptom duration longer than 6 months before surgery, and no previous episodes of acute cholecystitis. Conclusions: Symptoms categorized as dyspeptic were more likely to persistthan were biliary symptoms, although all symptoms showed a decrease in prevalence after cholecystectomy. More attention to the rationale for gallbladder removal and clarification of patient expectations for symptom relief might be necessary to improve outcomes after elective cholecystectomy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 14:45:43