The relationship between gastrointestinal complaints and the use of pancreatin-derivated medications after cholecystectomy

Year 2024, Volume: 37 Issue: 2, 208 - 213, 31.05.2024

Sefa Ergün , Betul Guzelyuz , Batuhan Tozakoglu , Osman Simsek Salih Pekmezci

https://doi.org/10.5472/marumj.1481286

Abstract

Objective: The aim of this study was to investigate the relationship between pancreatin-derived medications and the treatability of
gastrointestinal complaints after cholecystectomy.
Patients and Methods: The relationship between postoperative symptomatic status and the use of proton pump inhibitors (PPIs)
and pancreatin-derivated medications in patients admitted to our hepatobiliary surgery service who underwent cholecystectomy was
retrospectively analyzed. IBM SPSS Statistics 23 (IBM SPSS,Turkey) was used for statistical analysis. Descriptive statistical methods
(mean, standard deviation, median, frequency, ratio, minimum, maximum) were used to evaluate the study data. Pearson Chi-Square
Test and Fisher’s Exact test were used to compare qualitative data. Significance was evaluated at the p<0.05 level.
Results: Proton pump inhibitors and pancreatin-derivatives were prescribed to all patients in the postoperative period. Although, the
rate of postoperative asymptomatic course was higher in all patients, the rate of postoperative symptoms was found to be higher in
patients who received PPI and pancreatin therapy (p=0.001, p=0.022; p<0.01).
Conclusions: Although, the high rate of asymptomatic postoperative course in all patients indicates that cholecystectomy alone is
curative, some symptoms may persist in the postoperative period and it was found to be more frequent in patients who used PPI and
pancreatin-derived medications in the postoperative period.

Keywords

Cholecystectomy, Pancreatin-derivatives, Proton Pump Inhibitors, Dyspepsia

References

• Talley NJ, Silverstein MD, Agréus L, Nyrén O, Sonnenberg A, Holtmann G. AGA technical review: evaluation of dyspepsia. American Gastroenterological Association. Gastroenterology 1998;114:582-95. doi: 10.1016/s0016-5085(98)70542-6.
• Medic B, Babic Z, Banic M, Ljubicic L. Modern approach to dyspepsia. Acta Clin Croat 2021;60:731-8. doi: 10.20471/ acc.2021.60.04.21
• Çalışkan HM, Çelik B. Evaluation of management of patients who apply to emergency service with dyspeptic complaints. J Contemp Med 2021;11:640-6. doi:10.16899/jcm.913357
• Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG clinical guideline: Treatment of Helicobacter pylori infection. Am J Gastroenterol 2017;112:212-39. doi: 10.1038/ajg.2016.563.
• Kavitt RT, Lipowska AM, Anyane-Yeboa A, Gralnek IM. Diagnosis and treatment of peptic ulcer disease. Am J Med 2019;132:447-56. doi: 10.1016/j.amjmed.2018.12.009
• Talley NJ, Vakil NB, Moayyedi P. American gastroenterological association technical review on the evaluation of dyspepsia. Gastroenterology 2005;129:1756-80. doi: 10.1053/j. gastro.2005.09.020.
• Kırık A, Yekdeş AC, Ergün U, Alp B, Ak MN, Doğru T, Investigation of cholecystectomy frequency and associated factors in asymptomatic gallstones. Ahi Evran Med J 2021;5:3-7 doi: 10.46332/aemj.776273
• Löser C, Fölsch UR, Clinical and pharmacological aspects of pancreatic enzyme substitution therapy. Leber Magen Darm 1991;21:56-65.
• Pongprasobchai S. Maldigestion from pancreatic exocrine insufficiency. J Gastroenterol Hepatol 2013;28(Suppl 4):99- 102. doi: 10.1111/jgh.12406.
• Hammer HF. Pancreatic exocrine insufficiency: diagnostic evaluation and replacement therapy with pancreatic enzymes. Dig Dis 2010;28:339-43. doi: 10.1159/000319411.
• Huddy JR, Macharg FM, Lawn AM, Preston SR. Exocrine pancreatic insufficiency following esophagectomy. Dis Esophagus 2013;26:594-7. doi: 10.1111/dote.12004.
• Brennan GT, Saif MW, Pancreatic enzyme replacement therapy: A concise review. JOP 2019;20:121-5.
• Zhang J, Lu Q, Ren YF, et al. Factors relevant to persistent upper abdominal pain after cholecystectomy. HPB (Oxford) 2017;19:629-37. doi: 10.1016/j.hpb.2017.04.003.
• Ford AC, Marwaha A, Lim A, Moayyedi P. What is the prevalence of clinically significant endoscopic findings in subjects with dyspepsia? Systematic review and meta-analysis. Clin Gastroenterol Hepatol 2010;8:830-7. doi: 10.1016/j. cgh.2010.05.031.
• Moayyedi P, Lacy BE, Andrews CN, Enns RA, Howden CW, Vakil N. ACG and CAG clinical guideline: Management of dyspepsia. Am J Gastroenterol 2017;112:988-1013. doi: 10.1038/ajg.2017.154.
• Lankisch PG, Lembcke B, Göke B, Creutzfeldt W. Therapy of pancreatogenic steatorrhoea: does acid protection of pancreatic enzymes offer any advantage? Z Gastroenterol 1986;24:753-7.
• Sikkens EC, Cahen DL, Kuipers EJ, Bruno MJ. Pancreatic enzyme replacement therapy in chronic pancreatitis. Best Pract Res Clin Gastroenterol 2010;24:337-47. doi: 10.1016/j. bpg.2010.03.006.
• Phillips ME. Pancreatic exocrine insufficiency following pancreatic resection. Pancreatology 2015;15:449-55. doi: 10.1016/j.pan.2015.06.003
• Catarci M, Berlanda M, Grassi GB, Masedu F, Guadagni S. Pancreatic enzyme supplementation after gastrectomy for gastric cancer: a randomized controlled trial. Gastric Cancer 2018;21:542-51. doi: 10.1007/s10120.017.0757-y.