Severe gastrointestinal symptoms during first year after laparoscopic cholecystectomy.

Background & objective: Many patients after cholecystectomy, develop gastrointestinal (GI) symptoms and are worried. The objective of this study was to find out the risk factors for severe GI symptoms following laparoscopic cholecystectomy (LC) during first year of follow-up.

Methods: It is a multi-center prospective observational study. In this study, patients who underwent LC for gallstones as elective or emergency at different hospitals of Al-Ahsa region of the Kingdom of Saudi Arabia from January 2020 to December 2021were evaluated for the development of severe GI symptoms postoperatively. They were followed-up for one year after the surgery.

Results: One thousand and two patients who underwent LC, 139(13.87%) developed severe GI symptoms after LC. The patients affected were mostly females 103(74.1%). After LC, the GI symptoms observed were increased frequency of defecation 113(81.3%), loose stools 102 (73.4%), urgency 63(45.3%) and bloating 60 (43.16%) patients. Forty-seven (33.8%) patients had two GI symptoms at a time, followed by 36 (25.9%) who had three. The median time of the start of GI symptoms was two weeks after surgery and the symptoms ended at 12 weeks after surgery. Forty-five (32.4%) patients had less than three-weeks' duration, followed by 35(25%) having less than 15 weeks. A BMI more than 40 showed a significant association. A higher frequency of cholecystitis attacks and a delayed onset of GI symptoms showed a significant severity of GI symptoms, resulting in delayed resolution. The bowel symptoms were more prominent in the emergency group. Age and gender had no significance.

Conclusion: Early laparoscopic cholecystectomy of patients with cholelithiasis who have a smaller number of attacks of cholecystitis have less frequency of severe GI symptoms after the surgery.