ThTP6.8 Incidence and management of non-resolution of Biliary Colic or Right Upper Quadrant pain Post Laparoscopic Cholecystectomy

Abstract

Abstract Background The pathogenesis and risk of chronic pain after laparoscopic cholecystectomy are not well understood. Post-cholecystectomy syndrome describes persistence of biliary colic or right upper quadrant pain with a variety of GI symptoms, similar to features prior to cholecystectomy. It is attributed to biliary (retained stone, biliary stricture), extra-biliary (pancreatitis, gastritis, IBS) and psychiatric or neurological disorders. Aim To find out (1) the incidence of post laparoscopic cholecystectomy pain. (2) if patients were counselled on non-resolution of pain during consenting for surgery. (3) if patients were investigated for non-resolution of pain. Methodology Retrospective cohort study was performed by interviewing patients undergoing laparoscopic cholecystectomy from April2022-October2022. Direct telephone consultation to enquire about non-resolution of pain. Digital case notes were reviewed for subsequent admissions. Results A total of 50 cases met the audit inclusion criteria over the period of 7months. Mean age of the selected population was 47.98 years (SD 15.47). Male:female ratio was 11:39. 24%(n=12) patients were reported non-resolution of pain post-op. 48%(n=24) patients were counselled on non-resolution of pain while consenting for surgery. Discussion The study suggested a significant number of patients experience non-resolution of pain post-cholecystectomy. However, less than half of the study population were counselled during consenting. Limitations include low number of patients and risk factors like urgent surgery like ‘hot gallbladders’ and choledochotomy could not be assessed. To improve clinical practice, non-resolution of pain should be mentioned during consenting. Additionally, a potential follow-up system should be introduced to review non-resolution of pain and guidelines on investigation of the residual pain should be produced.