POST CHOLECYSTECTOMY AND THE DYSPEPTIC PATIENT TO IDENTIFYING THE APPROPRIATENESS OF OPERATIVE INTERVENTION IN CHENGALPATTU MEDICAL COLLEGE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 91
Abstract
BACKGROUND Dyspepsia is defined by the discomfort or pain localised in the upper abdomen. This pain is common with a prevalence of forty to sixty percent in the general population. But often 55% of patients do not have any underlying abnormality after doing upper GI investigations, but yet remain symptomatic. Dyspeptic symptoms can present for at least twenty five percent of times for a period of one month in absence of a definite disease. This is called as functional dyspepsia. The aim of the study was to identify whether early surgery in patients with uncomplicated gall stone disease and symptom of dyspepsia will give complete symptom resolution post-operatively. Based on this, we identified the appropriate timing interval of laparoscopic cholecystectomy for patients with uncomplicated gall stone disease and symptom of dyspepsia. The research objectives were1. To analyse if laparoscopic cholecystectomy in patients with gall stones and symptom of dyspepsia will give entire relief of symptom. The word entire relief of symptom means entire cessation of symptom of dyspepsia after LC. 2. To compare the changes in the pre-operative scores to the post-operative scores and satisfaction after LC in these two groups of patients, i.e. patients with gall stones and dyspeptic symptoms and patients with gall stones and no dyspeptic symptoms. 3. To determine the relationship between the duration of pre-operative episode and the complete resolution of symptoms following LC in patient with gall stones and symptom of dyspepsia. Duration is measured by the total time period between onset of symptom and LC. 4. To determine the relationship between the frequency of pre-operative episode and the complete resolution of symptom after LC in patient with gall stones and symptom of dyspepsia. Frequency is measured by the number of episodes in the period of time prior to LC. MATERIALS AND METHODS This observational study was carried out in Government Chengalpattu Medical College and Hospital Institution over a period of 1 year. All patients more than 18 years of age with uncomplicated gall stone disease attending our OPD was found to have gallstones disease by clinical examination and USG abdomen were included in this study. Sixty patients entered the study. Thirty patients (50%) had symptoms of dyspepsia (Group I) and thirty patients (50%) had no symptoms of dyspepsia (Group II). All patients were administered survey questionnaire, which deals with two aspects before surgery and 3 months after LC. This survey contains the validated dyspepsia score of “Buckley et al.” RESULTS After laparoscopic cholecystectomy, majority of the patients (76.7%) in Group I (dyspeptic) achieved complete symptomatic relief 3 months after the surgery as defined by a post-operative Buckley scores of less than 6. Only 23.3% of Group I (Dyspeptic) patients achieved a Buckley score more than 6. Based on the satisfaction after the surgery, 90% of Group I (dyspeptic) patients were either very satisfied or satisfied after surgery. CONCLUSION The inference of this study shows that Laparoscopic cholecystectomy in patients with gall stones and symptoms of dyspepsia got a better relief of dyspeptic symptoms post-operatively. Early timely intervention showed a significant change in the pre-operative to the post-operative symptoms and also a significant improvement in satisfaction after the surgery in the two groups of patients. Also the patients who had the symptoms for less than 3 months showed a better improvement in dyspeptic symptoms than the patients who had the symptoms for more than 3 months. 3 The patients who had the symptoms for less than or equal to 3 episodes showed a better outcome overall.
Authors and Affiliations
Shantha Kumar Kuzhanthaivelu
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- EP ID EP278557
- DOI 10.14260/Jemds/2017/1397
- Views 85
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