CONTRIBUTING FACTORS FOR CHRONIC DYSPEPSIA AMONG PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY IN NINEVEH PROVINCE-IRAQ

Background: Humans are frequently affected by gallstone disease. In addition to abdominal discomfort, gastrointestinal symptoms such dyspepsia, nausea, vomiting, and food intolerance can result from gallbladder stimulation caused by gallstones. With the advent of laparoscopic cholecystectomy, expected decline in the occurrence of post-cholecystectomy, however, several studies have revealed that improvements in abdominal symptoms may vary according on the patient's preoperative circumstances. Objectives: To assess the contributing factors for chronic dyspepsia among patients undergoing elective laparoscopic cholecystectomy in Nineveh province/Iraq. Methods: This is a prospective observational study conducted at Mosul General Hospital and Shingal (Sinjar) General Hospital From the 1st of November 2021 to the end of December 2023. After evaluation of each patient, the patients were all put on an elective procedure, and in every instance, ultrasonography verified the cholelithiasis diagnosis. Patients were excluded from the study if they did open surgery or if they could not comply with answering the questionnaires after surgery. The questionnaire includes four parts, part one for sociodemographic information of the study participants. Part two for anthropometric information. Part three for patients presenting symptoms and reached diagnosis and part four for persistence postoperative symptoms. Results: The study includes 200 patients with symptomatic gallstone. The mean age ± standard deviation of the study participants was 46.46 ± 6.82 years. Of them, 122 (61%) patients were females and 78 (39%) were males, with male to female ratio of 1:1.56. Moreover, 51 (25.5%) patients were active smokers, 23 (11.5%) patients report alcohol intake, 162 (81%) had overweight and obesity. Chronic cholecystitis was diagnosed in 166 (83%) patients. Furthermore, the majority of patients were presented with nausea and food intolerance, right hypochondrial pain, right shoulder radiating pain, their pain precipitate by heavy meal intake, and relieved by fasting. Additionally, 49 patients report persistence of postoperative symptoms and 25 patients report persistence postoperative pain. Statistically significant difference between patient with persistence postoperative dyspepsia and those without persistence dyspepsia regarding their active smoking state, alcohol intake, and presence of overweight and obesity (P value < 0.05). Conclusion: Patients with gallstones for which they did laparoscopic cholecystectomy reported high prevalence of persistence dyspepsia. Active smoking, alcohol intake, overweight and obesity increase the possibility of having such symptoms. It’s advisable to change these lifestyle factors to avoid this symptom.