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Which Abdominal Symptoms are Associated with Clinical Events in a Population Unaware of Their Gallstones? a Cohort Study

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

High rates of persistent symptoms are found following cholecystectomy in patients with gallstones. The aim of this population based cohort study was to determine which symptoms were associated with the development of clinical gallstone events in a population unaware of their gallstones.

Material and Methods

Three random population samples from Copenhagen (N = 6037) were examined with ultrasound during 1982–1994. Participants were not informed about gallstone status. Abdominal symptoms were assessed at baseline through a questionnaire. Follow-up for clinical events was performed through central registers until 2011. Multivariable Cox regression analyses were performed.

Results

Participants unaware of their gallstones (N = 595) were followed for median 17.5 years. A total of 16.6% participants developed clinical events. Both uncomplicated and complicated events were associated with high pain intensity at baseline. Complicated events were also associated with pain at night. Uncomplicated events were associated with pain localized in the epigastrium, of longer duration, and in need of pain medication. No associations were identified for dyspepsia or irritable bowel syndrome.

Conclusions

In a population of unaware gallstone carriers, it was possible to identify abdominal symptoms associated with later clinical detection of the gallstones. These finding may contribute to a better selection of patients for surgery.

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Acknowledgements

We would like to thank Anja Lykke Madsen for data management.

Grant Support

This study was financially supported by the Faculty of Health and Medical Sciences at the University of Copenhagen

Author Contributions

Daniel Mønsted Shabanzadeh: design, data analysis, interpretation of data, drafting of manuscript, and approval of final manuscript. Lars Tue Sørensen: design, interpretation of data, critical revision of manuscript, and approval of final manuscript. Torben Jørgensen: design, acquisition of data, interpretation of data, critical revision of manuscript, and approval of final manuscript.

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Authors and Affiliations

  1. Digestive Disease Center, Bispebjerg University Hospital, Bispebjerg Bakke 23, DK-2400, Copenhagen, Denmark

    Daniel Mønsted Shabanzadeh, Lars Tue Sørensen & Torben Jørgensen

  2. Research Centre for Prevention and Health, Capital Region of Denmark, Copenhagen, Denmark

    Daniel Mønsted Shabanzadeh & Torben Jørgensen

  3. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Lars Tue Sørensen

  4. Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Torben Jørgensen

  5. The Faculty of Medicine, Aalborg University, Aalborg, Denmark

    Torben Jørgensen

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  1. Daniel Mønsted Shabanzadeh
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Correspondence to Daniel Mønsted Shabanzadeh.

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Shabanzadeh, D.M., Sørensen, L.T. & Jørgensen, T. Which Abdominal Symptoms are Associated with Clinical Events in a Population Unaware of Their Gallstones? a Cohort Study. J Gastrointest Surg 21, 831–839 (2017). https://doi.org/10.1007/s11605-016-3349-y

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  • DOI: https://doi.org/10.1007/s11605-016-3349-y

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