Dynamics of Clinical Manifestations of Gastrointestinal Disorders in Postcholecystectomy Syndrome
Keywords:
postcholecystectomy syndrome, gastrointestinal disorders, dynamics of symptomsAbstract
Postcholecystectomy syndrome (PCS) remains a significant problem of modern gastroenterology, affecting up to 15-40% of patients after cholecystectomy. Gastrointestinal manifestations form the basis of the clinical picture of PCS, but their dynamic characteristics are insufficiently studied. Analyze the dynamics of clinical manifestations of gastrointestinal disorders in postcholecystectomy syndrome depending on the time periods after surgery and to determine the factors influencing the character and severity of symptoms. A prospective cohort study of 247 patients who underwent laparoscopic cholecystectomy between 2021 and 2024 was conducted. The mean age was 52.3±12.7 years. Clinical manifestations were assessed at 1, 3, 6, 12 and 24 months after surgery using standardized questionnaires and objective diagnostic methods. 89 patients (36,0%) developed PCS of different severity. The most frequent gastrointestinal manifestations were: diarrhea (67,4%), abdominal pain (58,4%), dyspeptic disorders (45,5%) and flatulence (41,6%). Maximum severity of symptoms was observed in the first 3 months after surgery with subsequent gradual decrease in intensity. Full adaptation of the gastrointestinal tract occurred on average in 12-18 months. The dynamics of gastrointestinal disorders in PCS is characterized by phasic course with maximum severity in the early postoperative period and gradual adaptation during the first two years.
References
1. Chen, L., Wang, H., Zhang, S., et al. (2022). Gut microbiome alterations after cholecystectomy: A systematic review and meta-analysis. Gastroenterology Research and Practice, 2022, 8847521. https://doi.org/10.1155/2022/8847521
2. Girometti, R., Intile, A., Zuiani, C., et al. (2021). Post-cholecystectomy syndrome: Spectrum of biliary findings at magnetic resonance cholangiopancreatography. Abdominal Radiology, 46(8), 3706-3717. https://doi.org/10.1007/s00261-021-03084-4
3. Kim, J. H., Park, S. H., Lee, D. H., et al. (2022). Long-term outcomes and predictive factors of post-cholecystectomy syndrome: A prospective cohort study. Journal of Gastroenterology and Hepatology, 37(4), 678-685. https://doi.org/10.1111/jgh.15768
4. Lammert, F., Gurusamy, K., Ko, C. W., et al. (2020). Gallstones. Nature Reviews Disease Primers, 6(1), 69. https://doi.org/10.1038/s41572-020-0200-5
5. Lee, M. K., Chen, Y. L., Wu, C. C., et al. (2022). Bile acid malabsorption and chronic diarrhea after cholecystectomy: A comprehensive review. World Journal of Gastroenterology, 28(31), 4336-4347. https://doi.org/10.3748/wjg.v28.i31.4336
6. Manes, G., Paspatis, G., Aabakken, L., et al. (2021). Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy, 53(7), 718-735. https://doi.org/10.1055/a-1324-7919
7. Martinez-Lopez, S., Rodriguez-Hernandez, H., Gonzalez-Angulo, A., et al. (2023). Pathophysiology and management of post-cholecystectomy syndrome: Current perspectives. Clinical and Experimental Gastroenterology, 16, 23-35. https://doi.org/10.2147/CEG.S389117
8. Rodriguez-Silva, C., Hernandez-Mora, J., Garcia-Fernandez, P., et al. (2023). Diagnostic algorithms for post-cholecystectomy syndrome: A systematic approach. Surgical Endoscopy, 37(8), 6234-6242. https://doi.org/10.1007/s00464-023-09876-5
9. Rustagi, T., & Romagnuolo, J. (2022). Post-cholecystectomy syndrome: A comprehensive review of diagnosis and management. Gastrointestinal Endoscopy, 95(4), 680-691.
https://doi.org/10.1016/j.gie.2021.12.034
10. Singh, A., Prakash, B., Kumar, S., et al. (2023). Biliary dysfunction after cholecystectomy: Mechanisms and therapeutic approaches. Journal of Clinical Medicine, 12(7), 2456.
https://doi.org/10.3390/jcm12072456
11. Тян Д. Л., Валиев Р. А., Пулатов С. С. ПОДВОДНОЕ ВЫТЯЖЕНИЕПОЗВОНОЧНИКА ПРИ ОСТЕОХОНДРОЗЕ //Journal of Healthcare and Life-Science Research. – 2024. – Т. 3. – №. 9. – С. 160-162
12. Pulatov S. S., Valiev R. A. RESPIRATORY PHYSIOTHERAPY INTERVENTIONS IN ACUTE VIRAL RESPIRATORY INFECTIONS: A COMPREHENSIVE THERAPEUTIC EXPLORATION //Экономика и социум. – 2023. – №. 12 (115)-1. – С. 581-582
13. Valiev R. A. Professional Athletes' Perspectives on the Function of Sports Medicine Specialists in Treating Psychosocial Aspects of Sport-Injury Rehabilitation //International Journal of Integrative and Modern Medicine. – 2024. – Т. 2. – №. 7. – С. 215-221.
14. Butabaev M. T., Valiyev R. A. NEUROREHABILITATION OF THE MUSCULOSKELETAL SYSTEM OF ATHLETES USING THE STRESS EFFECT OF NATURAL FACTORS //Ethiopian International Journal of Multidisciplinary Research. – 2023. – Т. 10. – №. 09. – С. 473-474
