JSSN 2013; 16 (2)
Original article
6\PSWRPDWLF2XWFRPH$IWHU/DSDURVFRSLF&KROHF\VWHFWRP\
Malla B R, Shrestha R K M
Correspondence to :'U%DOD5DP0DOOD$VVLVWDQW3URI'HSDUWPHQWRIVXUJHU\
'KXOLNKHO+RVSLWDO.DWKDPQGX8QLYHUVLW\+RVSLWDO*32.DWKPDQGX1HSDO
Email : 0DOODEU#\DKRRFRP
Abstract
Background: *DOOEODGGHUVWRQHSURGXFHVPDQ\V\PSWRPV6\PSWRPDWLFFKROHOLWKLDVLVLVWKHPRVW
common indication for laparoscopic cholecystectomy The objective of the study is to identify the
V\PSWRPVDVVRFLDWHGZLWKJDOOEODGGHUVWRQHDQGWRDQDO\]HWKHLPSURYHPHQWRIWKHVHV\PSWRPV
after laparoscopic cholecystectomy
Methods: 7KLV ZDV WKH LQWHUYLHZ EDVHG SURVSHFWLYH VWXG\ GRQH LQ SDWLHQWV ZKR XQGHUZHQW
ODSDURVFRSLFFKROHF\VWHFWRP\LQ.DWKPDQGXXQLYHUVLW\KRVSLWDOEHWZHHQ-DQXDU\WR'HFHPEHU
3DWLHQWVZHUHLQWHUYLHZHGXVLQJGHVLJQHG3HUIRUPDEHIRUHODSDURVFRSLFFKROHF\VWHFWRP\DQG
after six months of the operation.
Results: 2XWRISDWLHQWVZHUHIHPDOHDQGZHUHPDOH0HDQDJHZDV\HDUVUDQJHV
<HDUV$EGRPLQDOSDLQZDVIRXQGLQRIWKHFDVHVJRLQJIRUODSDURVFRSLFFKROHF\VWHFWRP\
6LPLODUO\ RWKHU SUHRSHUDWLYH V\PSWRPV ZHUH QDXVHD IDWW\ IRRG LQWROHUDQFH KHDUW
EXUQDQGYRPLWLQJ
$IWHUODSDURVFRSLFFKROHF\VWHFWRP\DEGRPLQDOSDLQZDVUHOLHYHGLQRIWKHFDVHV+RZHYHU
QDXVHD DQG KHDUW EXUQ SHUVLVWHG LQ DQG RI WKH FDVHV UHVSHFWLYHO\ DW PRQWKV RI WKH
operation
Conclusion: /DSDURVFRSLF FKROHF\VWHFWRP\ UHOLHYHV PRVW RI WKH V\PSWRPV DVVRFLDWHG ZLWK
symptomatic cholelithiasis.
Keywords : laparoscopic cholecystectomy, outcomes, symptoms
Introduction
DQG 'HFHPEHU LQ .DWKPDQGX 8QLYHUVLW\
+RVSLWDO'KXOLNKHO+RVSLWDO$WRWDORISDWLHQWVZHUH
LQFOXGHG LQ WKH VWXG\$OO WKH SDWLHQWV ZHUH FRQ¿UPHG WR
KDYH FKROHOLWKLDVLV DV SHU DEGRPLQDO XOWUDVRXQG $OO WKH
SDWLHQWVZHUHLQWHUYLHZHGXVLQJWKHGHVLJQHG3HUIRUPDLQ
preoperative period before LC and also after six months
7KLVVWXG\ZDVGRQHWRLQGHQWLI\WKHV\PSWRPVDVVRFLDWHG RI WKH RSHUDWLRQ 3DWLHQWV ZHUH FRQWDFWHG RQ WHOHSKRQH
ZLWK WKH JDOO EODGGHU VWRQH DQG WKH LPSURYHPHQWV RI WKH LQ IROORZ XS 7KRVH SDWLHQWV ZKR XQGHUZHQW RSHQ
symptoms after LC.
FKROHF\VWHFWRP\ DQG WKRVH ZKR KDG PDMRU FRPSOLFDWLRQV
OLNHELOHOHDNZHUHH[FOXGHGIURPWKHVWXG\3DWLHQWVZLWK
common bile duct stone , carcinoma of gall bladder and
Methods
WKRVHORVWWRIROORZXSZHUHDOVRH[FOXGHGIURPWKHVWXG\
7KLV ZDV D SURVSHFWLYH VWXG\ GRQH EHWZHHQ -DQXDU\ 7KHGDWDZHUHDQDO\]HGXVLQJ0LFURVRIW([FHO
/DSDURVFRSLF FKROHF\VWHFWRP\/&LV WKH PRVW FRPPRQ
VXUJHU\ SHUIRUPHG IRU V\PSWRPDWLF JDOO VWRQH +RZHYHU
symptoms persist even after the surgery in some patients.
The success of the surgery depends upon the improvement
RIWKHV\PSWRPVIRUZKLFKRSHUDWLRQZDVSODQQHG
JSSN
Journal of Society of Surgeons of Nepal
Malla B R ... 6\PSWRPDWLF2XWFRPH
JSSN 2013; 16 (2) 5- 6
Result
References
2XWRISDWLHQWVZHUHIHPDOHDQGZHUHPDOH0) 1.
UDWLR7KHPHGLDQDJHJURXSZDV\HDUV$EGRPLQDO
SDLQ ZDV IRXQG LQ RI WKH SDWLHQWV JRLQJ IRU /& DQG
RI WKH SDWLHQWV KDG QDXVHD LQ SUHRSHUDWLYH SHULRG
$IWHUVL[PRQWKVRI/&DEGRPLQDOSDLQZDVSHUVLVWDQWRQO\
LQRIWKHFDVHV+RZHYHUQDXVHDZHUHSHUVLVWDQWLQ RIWKHFDVHV
6LPLODUO\IDWW\ IRRG LQWROHUDQFH DQG KHDUW EXUQ ZDV
3.
SHUVLVWHQWLQDQGRIWKHFDVHVUHVSHFWLYHO\
Table 1 Preoperative and postoperative symptoms
Symptoms
Preop(n)
$EGRPLQDOSDLQ
Nausea
9RPLWLQJ
Fatty food
intolerance
+HDUWEXUQ
Postop at 6
months(n)
2P7DQWLD0D\DQN-DLQ6KDVKL.KDQQD%LPDOHQGX
6HQ3RVWFKROHF\VWHFWRP\6\QGURPH5ROHRIF\VWLF
GXFWVWXPSDQGUHLQWHUYHQWLRQ-0LQLP$FFHVV6XUJ
-XO6HS
%HUJHU 0< 2OGH KDUWPDQQ7& %RKQHQ $0
$EGRPLQDO 6\PSWRPV 'R WKH\ GLVDSSHDU DIWHU
FKROHF\VWHFWRP\"6XUJ(QGRVF
)LQDQ .5 /HHWK 55 :KLWOH\ %0 .ODSRZ -&
+DZQ07,PSURYHPHQWLQJDVWURLQWHVWLQDO6\PSWRPV
DQG TXDOLW\ RI OLIH DIWHU FKROHF\VWHFWRP\ $P -
6XUJ
*XUXVDP\.6-XQXUNDU6)DURXN0'DYLGVRQ%5
&KROF\VWHFWRP\IRU*DOEODGGHUG\VNLQHVLD&RFKUDQH
'DWDEDVHRIV\VWHPLFUHYLHZV&'
1LUDQMDQ % &KXPEHU 6 .ULSODQL $. 6\PSWRPDWLF
outcome after Laparoscopic Cholecystectomy. Trop
*DVWURHQWHURO-XO6HS
0RKDPPHG $PLU 0RKDPPDG =XEDLU ,QÀXHQFH RI
FKROHF\VWHFWRP\RQV\PSWRPDWLFFKROHOWKLDVLVFDQDOO
V\PSWRPVEHLPSURYHG"$ZO0HG-
Discussion
3DLQ DEGRPHQ DVVRFLDWHG ZLWK *DOO EODGGHU VWRQH JHW 4XHVKL 0$ %XUNH 3( %ULQGOH 10 /HDK\ $/
completely relieved after cholecystectomy . Similarly,
2VERUQH '+ %URH 3- 3RVWFKROHF\VWHFWRP\
1LUDQMDQ%HWDOKDGDOVRVKRZQDEGRPLQDOSDLQUHOLHYHGLQ
6\PSWRPV$IWHU/DSDURVFRSLF&KROHF\VWHFWRP\$QQ
RIWKHFDVHVDIWHU/&,QRXUVWXG\DEGRPLQDOSDLQLV
5&ROO6XUJ(PJO
UHOLHYHGLQRIWKHFDVHVDIWHU/&
)ROORZLQJ/&DOOWKHSDWLHQWVKDGQRYRPLWLQJ7KLV¿QGLQJ
LVFRPSDUDEOHWRWKHVWXG\GRQHE\0RKDPPHG$PLUHWDO
,QRXUVWXG\IDWW\IRRGLQWROHUDQFHDQG+HDUWEXUQZHUH
SHUVLVWHGLQDQGRIWKHFDVHVUHVSHFWLYHO\DIWHU
/&7KLVLVVLPLODUWRWKHVWXG\GRQHE\0RKDPPHG$PLU
et al
+RZHYHU QDXVHD ZDV IRXQG LQ RI WKH SDWLHQWV HYHQ
DIWHU /& 7KLV ZDV DOVR WUXH LQ WKH VWXG\ GRQH E\ 0$
Qureshi et al
Conclusion
/& UHOLHYHV PRVW RI WKH 6\PSWRPV $VVRFLDWHG ZLWK
6\PSWRPDWLF &KROHOLWKLDVLV $EGRPLQDO SDLQ YRPLWLQJ
DQG IDWW\ IRRG LQWROHUDQFH KDG EHWWHU RXWFRPH +RZHYHU
nausea and heart burn persisted after LC in greater number
of the patients.
JSSN
Journal of Society of Surgeons of Nepal