This study was amied clinically study on postcholecystectomy syndrome(PCS)
The postcholecystectomy syndrome is clinically one of main problems in the biliary surgery. This term now is used to describe a heterogenous collection of postcholecystectomy complaints. In the biliary lesion stone in Korea the location of stone
are
different from that of western. For the purpose to evaluate the incidence of this syndrome and the operative procedure, etiology of PCS, symptoms and signs, associated disease, management of PCS, attributing factors to PCS, etc
Author had done 35 cases of postcholecystectomy syndrome among 771 caes of biliary operation who treated at Kosin Medical Center(KMC), from Jan. 1982 to Aug. 1994.
@ES The results were as follows:
@EN 1) The incidence of postcholecystectomy syndrome was 4.5%(35 cases) and in the distribution of age and sex were similar
2) In the incidence of postcholecystectomy syndrome related to first operation. The postcholecystectomy syndrome from GB empyema were 5 cases(11.4%) and that from biliary stone was 718 cases, PCS from biliary stone were 30 cases(4.2%), GB stone
was 7
cases(2.1%) and that from GB and CBD stone was 11 cases(5.7%), CBD stone was 5 cases(3.6%) CBD and IHD stone were 5 cases(7.0%), IHD stone only was 1 cases(5.9%), GB, CBD and IHD stone was 1 case(10%).
3) In the incidence of postcholecystectomy syndrome related to first operative procedure cholecystectomy with T-tube choledochostomy was 24 cases(6.7%) only cholecystectomy was 7 cases(1.9%), cholecystectomy with Roux-en-Y choledochojejunostomy
was 3
cases(8.6%), cholecystectomy with T-tube and liver resection was 1 cases(11.1%)
4) The etiology of PCs distributed to intrincic and extrinsic Intrinsic factors were biliary stone 5 cases(14%), IHD stone was 3 cases(8%). CBD stone 2 cases(5.7%), biliary dyskinesia 5 cases(14%), Extrinsic 25 cases(72%), and then adhesin was
20
cases(57%), peptic ulcer 1 case(2.8%), pancreatitis 1 case(2.8%), unknown is 3 cases(8.5%).
5) The incidence of clinical symptoms of PCS were RUQ pain 25 caes(71%), nausea 3 cases(9%)vomiting 2 cases(6%), dyspesia 2 cases(6%), jaundice 1 case(3%), and fever 1 case(3%)
6) Diseases of non-operative cases in postcholecystectomy syndrome were liver cirrhosis 10 cases(29%), heptitis 2 cases(6%), peptic ulcer 2 cases(6%) and acute pancreatitis 2 cases(6%)
7) Management of PCS were surgical treatment and medical treatment, Surgical treatment was T-tube choledochostomy 2 cases(5.7%), Roux-en-Y choledochojejunostomy 3 cases(8.5%) Medical treatemtn was spasmolytics & analgesics 20 cases(57%), Ca++
channel
blocker 5 cases(14%), reassurance 3 cases(8.5%), H2 blocker & antacid 1 case(2.8%) and NPO& N-G sution 1 case(2.8%)
8) Attributing factors to PCS were similar at all age of life, among men and women status of disease were greater inflammation(5per 44 person, p<0.09) than stone (130 per 781, N-S) operation time >2hr were greater among >2hr operaion(17 per 241
eprson
<0.05) then <2hr operation time(18 per 530, N-S) status of operation were greater among emergency operation(23 per 119 person <0.0001) than elkective operation(12 per 652 person <0.001), operative method were greater among cholecystectomy with
other
procedure(28 per 400 person, <0.001) than cholecystectomy only, complication care(8 per 85 person, <0.05) were greater than no complication.
Postcholecystectomy syndrome was frequently disappeared in inflammatomy operation, emergency operation complicated state, in cholecystectomy with other operation and when operation time is over 2hr. duration and then if we were consider
meticulously
operation and prepared this situation. We can decreased postocholecystectomy syndrome.
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