{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:57:33Z","timestamp":1791835053098,"version":"4.3.4"},"reference-count":15,"publisher":"BMJ","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1993,10]]},"abstract":"<jats:p>The pre and postoperative symptoms and outcome after surgery in patients with symptomatic gall stone disease were evaluated by a detailed self administered postal questionnaire. The survey was conducted in two groups: 80 patients treated by laparoscopic cholecystectomy and an age matched cohort of patients who had conventional open cholecystectomy. The overall response rate on which the data were calculated was 76%. Symptomatic benefit ratios accruing from the surgical removal of the gall bladder were calculated. The symptoms that were relieved by cholecystectomy were nausea (0.98), vomiting (0.91), colicky abdominal pain (0.81), and backpain (0.76). Flatulence, fat intolerance, and nagging abdominal pain were unaffected as shown by a benefit ratio of 0.5 or less. Relief of heartburn (39\/49) outweighed the de novo development of this symptom after cholecystectomy (7\/49), resulting in a benefit ratio of 0.65. Postcholecystectomy diarrhoea occurred in 21\/118 patients (18%): 10 after open cholecystectomy and 11 after laparoscopic cholecystectomy. The type of surgical access did not influence the symptomatic outcome but had a significant bearing on the time to return to work or full activity after surgery (laparoscopic cholecystectomy two weeks, open cholecystectomy eight weeks, p = 0.00001). In the elderly age group (&gt; 60 years), significantly more patients (29\/30) regained full activity after laparoscopic cholecystectomy when compared with the open cholecystectomy group (16\/22), p = 0.001. The patient appreciation of a satisfactory cosmetic result was 72% in the open group compared with 100% of patients who were treated by laparoscopic cholecystectomy (p = 0.0017). Despite the persistence or de novo occurrence of symptoms, 111\/117 patients (95%) considered that they had obtained overall symptomatic improvement by their surgical treatment and 110\/118 (93%) were pleased with the end result regardless of the access used.<\/jats:p>","DOI":"10.1136\/gut.34.10.1448","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"1448-1451","source":"Crossref","is-referenced-by-count":68,"title":["Outcome after cholecystectomy for symptomatic gall stone disease and effect of surgical access: laparoscopic v open approach."],"prefix":"10.1136","volume":"34","author":[{"given":"G C","family":"Vander Velpen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S M","family":"Shimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Cuschieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1993,10,1]]},"reference":[{"key":"ref_1","first-page":"4","article-title":"Cholecystectomy and gallbladder conservation","volume-title":"BrJ7 Surg","volume":"79","author":"Walsh, T.N.; Russell, R.C.G.","year":"1992","unstructured":"Walsh TN, Russell RCG. Cholecystectomy and gallbladder conservation. BrJ7 Surg 1992; 79: 4-5."},{"key":"ref_2","first-page":"401","volume":"31","author":"Jones, R.H.; Lydeard, S.E.; Hobbs, F.D.R.; Kenkre, J.E.; Williams, E.I.; Jones, S.J.","year":"1990","unstructured":"Jones RH, Lydeard SE, Hobbs FDR, Kenkre JE, Williams EI, Jones SJ, et al. Dyspepsia in England and Scotland. Gut 1990; 31: 401-5.","journal-title":"Dyspepsia in England and Scotland. Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/0002-9610(89)90420-0","article-title":"The alkaline shift in gastric pH after cholecystectomy","volume":"157","author":"Brown, T.H.; Walton, G.; Cheadle, W.G.; Larson, G.M.","year":"1989","unstructured":"Brown TH, Walton G, Cheadle WG, Larson GM. The alkaline shift in gastric pH after cholecystectomy. Am j Surg 1989; 157: 58-65.","journal-title":"Am j Surg"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1136\/gut.17.12.965","article-title":"Idiopathic bile acid catharsis","volume":"17","author":"E, Hess Thaysen; L, Pedersen","year":"1976","unstructured":"Hess Thaysen E, Pedersen L. Idiopathic bile acid catharsis. Gut 1976; 17: 965-70.","journal-title":"Gut"},{"key":"ref_5","first-page":"753","article-title":"Cholecystectomy and oesophageal reflux","volume":"78","author":"Walsh, T.N.; Jazrawi, S.; Byrne, P.J.; Li, H.; Hennessy, T.P.J.","year":"1991","unstructured":"Walsh TN, Jazrawi S, Byrne PJ, Li H, Hennessy TPJ. Cholecystectomy and oesophageal reflux. BrJ Surg 1991; 78: 753.","journal-title":"BrJ Surg"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1136\/gut.28.11.1500","article-title":"Postcholecystectomy symptoms. 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A prospective analysis of 100 initial patients","volume":"213","author":"Peters, J.H.; Ellison, E.C.; Innes, J.T.; Liss, J.L.; Nichols, K.E.; Lomano, J.M.","year":"1991","unstructured":"Peters JH, Ellison EC, Innes JT, Liss JL, Nichols KE, Lomano JM, et al. Safety and efficiency of laparoscopic cholecystectomy. A prospective analysis of 100 initial patients. Ann Surg 1991; 213: 3-12."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1001\/archsurg.1992.01420040042006","article-title":"Twelve hundred open cholecystectomies before the laparoscopic era","volume":"127","author":"Morgenstern, L.; Wong, L.; Berci, G.","year":"1992","unstructured":"Morgenstern L, Wong L, Berci G. Twelve hundred open cholecystectomies before the laparoscopic era. Arch Surg 1992; 127: 400-3.","journal-title":"Arch Surg"},{"key":"ref_10","article-title":"A prospective randomized, placebo-controlled double-blind trial of whole body disinfection in the prevention of postoperative wound infections in elective surgery. BrJr Surg","author":"Byrne, D.J.; Napier, A.; Lynch, W.; Cuschieri, A.","unstructured":"Byrne DJ, Napier A, Lynch W, Cuschieri A. A prospective randomized, placebo-controlled double-blind trial of whole body disinfection in the prevention of postoperative wound infections in elective surgery. BrJr Surg (in press)."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/S0039-6109(16)43182-8","article-title":"Complications of cholecystectomy","volume":"63","author":"Henry, M.L.; Carey, L.C.","year":"1983","unstructured":"Henry ML, Carey LC. Complications of cholecystectomy. Surg Clin North Am 1983; 63: 1191-204.","journal-title":"Surg Clin North Am"},{"key":"ref_12","first-page":"114","article-title":"Comparison of early postoperative results for laparoscopic versus standard open cholecystectomy","volume":"174","author":"Soper, N.; Barteau, J.A.; Clayman, R.V.; Ashley, S.W.; Dunnegan, D.L.","year":"1992","unstructured":"Soper N, Barteau JA, Clayman RV, Ashley SW, Dunnegan DL. Comparison of early postoperative results for laparoscopic versus standard open cholecystectomy. Surg Gynecol Obstet 1992; 174: 114-8.","journal-title":"Surg Gynecol Obstet"},{"key":"ref_13","first-page":"396","article-title":"Interruption of professional and home activity after laparoscopic cholecystectomy among French and American patients","volume":"161","author":"Vitale, G.C.; Collet, D.; Larson, G.M.; Cheadle, W.G.; Miller, F.B.; Perissat, J.","year":"1991","unstructured":"Vitale GC, Collet D, Larson GM, Cheadle WG, Miller FB, Perissat J. Interruption of professional and home activity after laparoscopic cholecystectomy among French and American patients. AmjfSurg 1991; 161: 396-8.","journal-title":"AmjfSurg"},{"key":"ref_14","first-page":"385","article-title":"The European experience with laparoscopic cholecystectomy","volume":"161","author":"Cuschieri, A.; Dubois, F.; Mouiel, J.; Mouret, P.; Buess, G.; Troidi, H.","year":"1991","unstructured":"Cuschieri A, Dubois F, Mouiel J, Mouret P, Buess G, Troidi H, et al. The European experience with laparoscopic cholecystectomy. AmjSurg 1991; 161: 385-7.","journal-title":"AmjSurg"},{"key":"ref_15","first-page":"964","article-title":"Influence of cholecystectomy on symptoms","volume-title":"Br3r Surg","volume":"78","author":"Bates, T.; Ebbs, SR, Harrison; M, A.'Hern; R.P.","year":"1991","unstructured":"Bates T, Ebbs SR, Harrison M, A'Hern RP. Influence of cholecystectomy on symptoms. Br3r Surg 1991; 78: 964-7."}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.34.10.1448","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T05:28:42Z","timestamp":1765603722000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.34.10.1448"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,10]]},"references-count":15,"journal-issue":{"issue":"10","published-online":{"date-parts":[[1993,10,1]]},"published-print":{"date-parts":[[1993,10]]}},"alternative-id":["10.1136\/gut.34.10.1448"],"URL":"https:\/\/doi.org\/10.1136\/gut.34.10.1448","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,10]]}}}