Improved predictors of outcome in postcholecystectomy pain

Mark Topazian, Jo Ann Hong-Curtis, Jiayi Li, Carolyn Wells

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Background: Endoscopic interventions have limited efficacy in sphincter of Oddi dysfunction (SOD) Type 3, Improved predictors of response to treatment are needed. Methods: Patients with postcholecystectomy pain underwent a standardized history and physical examination and were then managed individually. Long-term outcome was determined by record review and telephone interview, Initial predictors of response to treatment were assessed. Results: Mean follow-up for the 74 subjects was 36 months. Fifty were improved, and 24 had persistent pain. Patients were likely to respond to sphincterotomy if their pain was not continuous, if it was accompanied by nausea or vomiting, and if there had been a pain free interval after cholecystectomy of at least 1 year. When 2 or 3 of these predictors were present, 85% of SOD Type 2 patients and 56% of Type 3 patients had a good response. Initial history and examination features also predicted response to treatment of neuropathic pain, Conclusion: Among patients with postcholecystectomy pain, specific features of the initial history and examination predict response to treatment with higher accuracy than the SOD grade. These predictors identify a subset of Type 3 patients likely to respond to sphincterotomy.

Original languageEnglish (US)
Pages (from-to)692-696
Number of pages5
JournalJournal of clinical gastroenterology
Volume38
Issue number8
DOIs
StatePublished - Sep 1 2004

Keywords

  • Abdominal pain
  • Cholecystectomy
  • Sphincter of Oddi dysfunction

ASJC Scopus subject areas

  • Gastroenterology

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