Frequency of Post-Cholecystectomy Syndrome in Laparoscopic Cholecystectomy Patients of a Tertiary Care Hospital of Punjab

Jamil   Salamat Ullah; Muhammad Ali  Akbar; Muhammad Omar   Farooq; Shafqat  Rehman; Raza  Haider

doi:10.51253/pafmj.v76iSUPPL-6.13947

Authors

Jamil Salamat Ullah Department of General Surgery, Combined Military Hospital, Malir/National University of Medical Sciences (NUMS) Pakistan
Muhammad Ali Akbar Department of General Surgery, Combined Military Hospital, Badin /National University of Medical Sciences (NUMS) Pakistan
Muhammad Omar Farooq Department of General Surgery, Combined Military Hospital, Multan /National University of Medical Sciences (NUMS) Pakistan
Shafqat Rehman Department of General Surgery, Combined Military Hospital, Peshawar /National University of Medical Sciences (NUMS) Pakistan
Raza Haider Department of General Surgery, Combined Military Hospital, Quetta /National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-6.13947

Keywords:

Abdominal pain, Cholecystectomy, Gallstone, Laparoscopy, Post-Cholecystectomy Syndrome

Abstract

Objective: To measure the frequency of post-cholecystectomy syndrome and to evaluate its association with demographic and clinical factors among patients undergoing laparoscopic cholecystectomy.

Study Design: Cross-sectional analytical study.

Place and Duration of Study: Unit I, Department of Surgery, Combined Military Hospital, Karachi, Pakistan, from Jan to Dec 2024.

Methodology: A sample of 150 participants was subjected to laparoscopic cholecystectomy under general anesthesia, and they were followed for one year for development of post-cholecystectomy syndrome (PCS). Demographics and frequency of post-cholecystectomy syndrome were noted down, and its association with demographic and clinical factors was studied. The significance was calculated with the help of appropriate statistical tests (chi-square analysis), and the p-value <0.05 was considered significant.

Results: The frequency of post-cholecystectomy syndrome was 18%, and its significant association with age (p-value=0.01), with highest frequency noted between ages 40 and 60 years. Other parameters, including gender, body mass index, comorbid conditions (diabetes mellitus, hypertension, and smoking), and length of symptoms, did not show any substantial association.

Conclusion: The post-cholecystectomy syndrome continues to affect a considerable proportion of patients after laparoscopic cholecystectomy, particularly those in midlife. These findings highlight the importance of attentive postoperative follow-up and a broader diagnostic approach that considers both biliary and non-biliary causes of persistent symptoms.

Downloads

Download data is not yet available.

References

1. Ng C, Ejimakor M, Goldson TM, Forjuoh SN. The postcholecystectomy syndrome in morbid obesity. Baylor Univ Med Center Proceedings 2020; 33(3): 393–394.

https://doi.org/10.1080/08998280.2020.1757975

2. Isherwood J, Oakland K, Khanna A. A systematic review of the aetiology and management of post-cholecystectomy syndrome. Surgeon 2019; 17(1): 33–42.

https://doi.org/10.1016/j.surge.2018.04.001

3. Bordoni B. Post cholecystectomy pain syndrome: Letter to Editor. Scand J Pain. 2024; 24(1).

https://doi.org/10.1515/sjpain-2024-0001

4. Shirah BH, Shirah HA, Zafar SH, Albeladi KB. Clinical patterns of postcholecystectomy syndrome. Ann Hepato-Biliary-Pancreatic Surg 2018; 22(1): 52–57.

https://doi.org/10.14701/ahbps.2018.22.1.52

5. Rahman KR, Fatima R, Zeenat M, Williams C, Khatun A, Yangibaev O et al. Evaluation of Post-cholecystectomy Syndrome in Patients With Gallstone Disease: A Critical Appraisal. Cureus 2025; 17(8).

https://doi.org/10.7759/cureus.90965

6. Sun Y, Zhang Y, Wang Z, Liu Q, Mo J. Efficacy and safety of Chinese herbal medicine in treating postcholecystectomy diarrhea: A systematic review and meta-analysis. Medicine 2024; 103(18): e38046.

https://doi.org/10.1097/MD.0000000000038046

7. Zackria R, Lopez RA. Postcholecystectomy Syndrome. 2023 Aug 28. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan–.

8. Gupta MS, Srivastava KN, Jain M, Chauhan A. Effect of Laparoscopic Cholecystectomy in Alleviating Dyspeptic Symptoms in Patients with Cholelithiasis. J Surg Res 2020; 3(2): 119-134.

9. Zhou H, Xuan F, Liu M. Incidence risk and risk factors for postcholecystectomy syndrome: A systematic review and meta-analysis. Medicine 2026; 105(7): e47687.

https://doi.org/10.1097/md.0000000000047687

10. Shrestha R, Chayaput P, Wongkongkam K, Chanruangvanich W. Prevalence and predictors of postcholecystectomy syndrome in Nepalese patients after 1 week of laparoscopic cholecystectomy: a cross-sectional study. Scientific Reports 2024; 14(1): 4903.

https://doi.org/10.1038/s41598-024-55625-1

11. Hamid M, Mostafa OES, Kausar M, Amin A, Olajumoke O, Singhal A et al. Emergency Laparoscopic Cholecystectomy Pathway Reduces Elective Waiting Times and Preoperative Admissions: A Prospective Propensity-Matched Cohort Study. Med Sci 2025; 13(3): 86.

https://doi.org/10.3390/medsci13030086

12. Womack NA, Crider RL. The Persistence of Symptoms Following Cholecystectomy. Ann Surg 1947; 126(1): 31-55.

https://doi.org/10.1097/00000658-194707000-00004

13. Bozhkov VM, Chernopolsky PM. Postcholecystectomy Syndrome: Diagnosis and Therapeutic Strategy. Surgery, Gastroenterol Oncol 2024; 29(2-Supplement): 5.

https://doi.org/10.21614/sgo-652

14. Latenstein CS, Wennmacker SZ, de Jong JJ, van Laarhoven CJ, Drenth JP, de Reuver PR. Etiologies of long-term post-cholecystectomy symptoms: a systematic review. Gastroenterol Res Pract 2019; 2019: 4278373.

https://doi.org/10.1155/2019/4278373

15. Arora D, Kaushik R, Kaur R, Sachdev A. Post-cholecystectomy syndrome: a new look at an old problem. J Minimal Access Surg 2018; 14(3): 202–207.

https://doi.org/10.4103/jmas.JMAS_92_17

16. Lee H, Askar A, Makanji D, Ranjha K, Karki BB, Courcol J, Kukreja Y, Niraj G. The incidence of post cholecystectomy pain (PCP) syndrome at 12 months following laparoscopic cholecystectomy: a prospective evaluation in 200 patients. Scand J Pain 2024; 24(1): 20230067.

https://doi.org/10.1515/sjpain-2023-0067

17. Samad M, Amin S, Iqbal S, Tahir R, Alam I. Frequency of biliary complications after laparoscopic cholecystectomy. Prof Med J 2025; 32(11): 1438-1442.

https://doi.org/10.29309/TPMJ/2025.32.11.9849

18. Alotaibi AM. post-cholecystectomy syndrome: A cohort study from a single private tertiary center. J Taibah Univ Med Sci 2022; 18(2):383-389. https://doi.org/10.1016/j.jtumed.2022.10.004.

19. Nam C, Lee JS, Kim JS, Lee TY, Yoon YC. Clinical perspectives on post-cholecystectomy syndrome: a narrative review. Ann Med 2025; 57(1): 2496408.

https://doi.org/10.1080/07853890.2025.2496408

20. Kegnæs M, Novovic S, Shabanzadeh DM. Dysfunction of Biliary Sphincter of Oddi-Clinical, Diagnostic and Treatment Challenges. J Clin Med 2023; 12(14): 4802.

https://doi.org/ 10.3390/jcm12144802

21. Saleem S, Weissman S, Gonzalez H, et al. post-cholecystectomy syndrome: a retrospective study analysing the associated demographics, aetiology, and healthcare utilization. Translat Gastroenterol Hepatol 2021; 6: 58.

https://doi.org/10.21037/tgh.2019.11.08

22. Aldahshan AA, Salamah AR, Fayoumi NM, et al. An overview on post-cholecystectomy syndrome diagnostic & management approach. Arch Pharmacy Practice 2021; 12(4): 38–41.

https://doi.org/10.51847/OteX8PLCKi

23. Mahfouz ME, Altowairqi AD, Alghamdi HY, Alzahrani MS, Alqurashi AK, Alhuraity TH, et al. Prevalence and factors associated with post-cholecystectomy syndrome in Saudi Arabia. Cureus 2022; 14(12).

https://doi.org/10.7759/cureus.32827