Postcholecystectomy syndrome: symptom clusters after laparoscopic cholecystectomy

Abstract

Purpose: Postcholecystectomy syndrome (PCS) is characterized by abdominal symptoms following gallbladder removal. However, there is no consensus for the definition or treatment for PCS. The purpose of this study was to define PCS among various symptoms after laparoscopic cholecystectomy, and to identify risk factors affecting PCS.

Methods: This study was conducted at Dongguk University Ilsan Hospital and Chung-Ang University Hospital (2012-2013). Outcomes were assessed using European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire. Symptom cluster for determining PCS was made by factor analysis. Cluster analysis evaluating risk factors of PCS was made by Ward methods and Dentogram.

Results: Factor analysis revealed three distinct symptom clusters, those are 'insomnia and financial difficulties (eigenvalue, 1.707; Cronbach α, 0.190),' 'appetite loss and constipation (eigenvalue, 1.413; Cronbach α, 0.480),' and 'right upper quadrant (RUQ) pain and diarrhea (eigenvalue, 1.245; Cronbach α, 0.315).' Among these symptom clusters, the cluster of 'RUQ pain and diarrhea' was determined as PCS. However, we could not find any risk factors between high symptomatic group and low symptomatic group.

Conclusion: PCS could consist of RUQ pain and diarrhea. Well-designed prospective trials are needed to determine risk factors of PCS.

Keywords: Cholecystectomy; Postcholecystectomy syndrome; Quality of life.

Fig. 1. To determine whether distinct subgroups of patients experiencing differing levels of symptoms burden might be having PCS, we modeled our cluster analysis on Ward methods and Dentogram. After cluster analysis, two patient subgroups, the high and low symptomatic group for PCS, were identified. PCS, postcholecystectomy syndrome.