Does Every Patient with Symptomatic Gallstones Need Cholecystectomy?

Kamran  Cheema; Muhammad  Azeem; Nawaz  Anjum; Ahmad  Raza

doi:10.29054/apmc/2024.1363

Kamran Cheema Assistant Professor, Department of Surgery, Sahara Medical College, Narowal Pakistan
Muhammad Azeem Professor, Department of Surgery, Sahara Medical College, Narowal Pakistan
Nawaz Anjum Associate Professor, Department of Surgery, University College of Medicine and Dentistry (UCMD), Lahore Pakistan
Ahmad Raza Assistant Professor, Department of Surgery, University College of Medicine and Dentistry (UCMD), Lahore Pakistan

DOI: https://doi.org/10.29054/apmc/2024.1363

Keywords: Gallstone colic, Atypical biliary colic, Heartburn, H. pylori, Ineffective cholecystectomy

Abstract

Objective: The aim of this study is to identify the impact of preoperative clinical symptoms of biliary colic –whether classic, dyspeptic or atypical type- on operative or non-operative clinical outcome. Study Design: Prospective study. Settings: Department of Surgery, Sargodha Medical College, Sargodha Pakistan. Duration: 15-01-2016 to 01-12-2017. Methods: Randomize control trial. Results:106 patients with cholelithiasis were evaluated, out of which 86.79% (n- 92) underwent cholecystectomy. 91.3% (n-84) were asymptomatic postoperatively. More than 50% patients presented with associated symptoms like GIRD/reflux, dyspepsia (n-57). Heartburn/reflux patients were unresolved postoperatively (P=0.03). Overall, 12.2% (n-13) of patients and 21.2% of patients with associated symptoms improve with medical treatment of peptic ulcer/H-pylori triple regimen therapy pre/postoperatively. Conclusion: Patients with symptomatic gall stone associated with atypical presentation, may benefit from PPI treatment or H. pylori testing before cholecystectomy.