Long-term follow-up after open cholecystectomy
The long-term outcome of open cholecystectomy was investigated. Follow-up data at a median of 10 years were obtained from physicians ' records on 325 (92.6 per cent) of 351 patients treated for symptomatic gallbladder stones by open cholecystectomy between 1978 and 1980. One 79-year-old patient died after operation, from a pulmonary complication. Of the 325 patients, 81.5 per cent were currently asymptomatic or had not had symptoms during follow-up until death. Sixty patients (18.5 per cent) had complaints after 10 years. Stone recurrence was found in jive patients (1.5 per cent); ten others (3.1 per cent) had biliary tract-related complaints during follow-up. Blood samples were obtained in 67.3 per cent of surviving patients with biliary complaints. There were no laboratory findings associated with biliary obstruction. Patients with typical symptoms of gallstone disease before surgery had signijicantly fewer complaints during follow-up than those with typical as well as atypical symptoms (14.8 versus 26.5 per cent, P < 0.02). However, most of these complaints were not related to the procedure. It is concluded that the majority of patients reported no complaints or postcholecystectomy symptoms 10 years after Maa'stric'ht, The Netherlands surgery.
Cholecystectomy is still the 'gold standard' for the treatment of symptomatic gallstones, especially after the introduction of the laparoscopic technique'.'. However, postcholecystectomy symptoms have been reported3z4 in 12-47 per cent of patients in follow-up periods ranging from 24 to 45 months. Follow-up in most studies of open cholecystectomy has been short, and such reports have been restricted mostly to a limited number of patient^^-^. The number of patients suffering from postcholecystectomy symptoms and recurrent gallstone disease during prolonged follow-up is unknown. It has been suggested on the basis of a prospective study that a relationship exists between preoperative symptoms such as dyspepsia and outcome after surgery3. In contrast, a more recent cohort study did not confirm this5. The present study therefore evaluated complaints 10 years after conventional cholecystectomy and attempted to relate these to preoperative symptoms.