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The aim of the research was to investigate the remote results of surgical treatment of 75 patients with cholelithiasis combined with chronic duodenal obstruction. Control group was composed of 40 patients who underwent laparoscopic cholecystectomy. Compensated stage of cholelithiasis with chronic duodenal obstruction was detected in 16 (21.3%) patients, subcompensated in 37 (49.3%) and decompensated stage in 17 (22.7%) patients. In 14 patients (18.7%) with cholelithiasis combined with chronic duodenal obstruction laparoscopic cholecystectomy was conducted due to the positive results of preoperative conservative treatment. In the long-term quality of life after surgery in the main group of patients were average 35.4% higher than in the control group; in the main group postcholecystectomical syndrome was diagnosed in one case (2,1%) and in 13 (32,2%) cases in the control group.

The association between cholelithiasis and depression remains unclear. We examined the risk of depression in patients with cholelithiasis. From the National Health Insurance population claims data of Taiwan, we identified 14071 newly diagnosed cholelithiasis patients (4969 symptomatic and 9102 asymptomatic) from 2000 to 2010. For each cholelithiasis patient, 4 persons without cholelithiasis were randomly selected in the control cohort from the general population frequency matched by age, sex, and diagnosis year. Both cohorts were followed up until the end of 2011 to monitor the occurrence of depression. Adjusted hazard ratios (aHRs) of depression were estimated using the Cox proportional hazards model after controlling for age, sex and comorbidities. The overall incidence rates of depression were 1.87- and 1.83-fold greater in the symptomatic and asymptomatic cholelithiasis subcohorts than in the control cohort (incidence, 10.1 and 9.96 vs 5.43 per 1000 person-years, respectively). The multivariable Cox proportional hazards regression analysis revealed higher variable-specific aHRs in women than in men, in younger patients than in older patients, and in those without comorbidities than in those with any comorbidity. Cholecystectomy reduced the hazard of developing depression with aHRs of 0.79 (95% confidence interval [CI] 0.62-0.99) for symptomatic cholelithiasis patients and 0.76 (95% CI 0.60-0.96) for asymptomatic patients. Patients with cholelithiasis are at a higher risk of developing depression than the general population. Patients could be benefited from cholecystectomy and have the hazard of developing depression significantly reduced.

A comparative clinical study of 136 female patients with uncomplicated chronic calculous cholecystitis, including 106 patients examined in the pre- and postoperative periods of endoscopic cholecystectomy, revealed the effect of chronic illness and surgery on the neurological status and cognition which was more pronounced in adulthood. We investigated anxiety feelings before and after surgery. Our findings should be taken into consideration in the preoperative preparation of patients and their care in the postoperative period.

Purpose: The objective of this study was to investigate the association of quality-of-life status with baseline laboratory findings among Taiwanese adults having symptomatic gallstone disease., Methods: A prospective quality-of-life survey was administered at a tertiary referral medical center among 102 consecutive adults with symptomatic gallstone disease. Patients underwent regular laboratory testing at admission and were evaluated using the 36-Item Short-Form Health Survey (SF-36) and the Gastrointestinal Quality of Life Index (GIQLI). Correlation and regression models were used to investigate quality-of-life predictors., Results: Compared with the general Taiwanese adult population, patients having symptomatic gallstone disease had significantly poorer performance on all eight SF-36 subscales (P < 0.001). Total GIQLI showed moderate to strong correlation with all eight SF-36 subscale scores (gamma = 0.29 ~ 0.62, P < 0.05). In multivariate analysis, serum levels of direct bilirubin (beta = -32.6, P = 0.001) and alkaline phosphatase (beta = -13.6, P = 0.032) were predictive of worse total GIQLI (adjusted R (2) = 0.183)., Conclusions: Symptomatic gallstone disease may considerably affect patient quality of life in terms of general health status and gastrointestinal-specific measures. Before gallstone surgery, serum levels of direct bilirubin and alkaline phosphatase significantly correlated with quality-of-life measures and can be used to evaluate patient well-being at admission.

Background: No cause has been determined for chest pain that is neither cardiac nor oesophageal in origin., Aims: To compare the prevalence of life-time psychiatric disorders and current psychological distress in three consecutive series of patients with chronic chest or abdominal pain., Patients: Thirty nine patients with non-cardiac chest pain and no abnormality on oesophagogastroduodenoscopy, oesophageal manometry, and 24 hour pH monitoring; 22 patients with non-cardiac chest pain having endoscopic abnormality, oesophageal dysmotility, and/or pathological reflux; and 36 patients with biliary colic., Methods: The Diagnostic Interview Schedule and the 28 item General Health Questionnaire were administered to all patients., Results: Patients with non-cardiac chest pain and no upper gastrointestinal disease had a higher proportion of panic disorder (15%), obsessive-compulsive disorder (21%), and major depressive episodes (28%) than patients with gallstone disease (0%, p < 0.02; 3%, p < 0.02; and 8%, p < 0.05, respectively). In contrast, there were no differences between patients with non-cardiac chest pain and upper gastrointestinal disease and patients with gallstone disease in any of the DSM-111 defined lifetime psychiatric diagnoses. Using the General Health Questionnaire, 49% of patients with non-cardiac chest pain without upper gastrointestinal disease scored above the cut off point (that is, more than 4), which was considered indicative of non-psychotic psychiatric disturbance, whereas only 14% of patients with gallstones did so (p < 0.005). The proportions of such cases were however similar between patients with non-cardiac chest pain and upper gastrointestinal disease (27%) and patients with gallstones., Conclusions: Psychological factors may play a role in the pathogenesis of chest pain that is neither cardiac nor oesophagogastric in origin.

We carried out a case-controlled study of multiple psychological and social factors in 49 men with complicated or uncomplicated peptic ulcer disease. Thirty-two men with renal stones or gallstones and 20 healthy men served as controls. Ulcer patients and controls experienced a similar number of potentially stressful life events. However, ulcer patients perceived their events more negatively (p less than 0.05). Ulcer patients also had significantly more personality disturbances than controls, although no one type of "ulcer personality" was found consistently. Some ulcer patients tended to be hypochondriacal complainers, overly pessimistic, and excessively dependent. Other personality disturbances were also more common in ulcer patients (e.g., immaturity, impulsivity, and feelings of social isolation and alienation). Ulcer patients had significantly lower ego strength and they had fewer friends and relatives whom they felt they could call upon in times of crisis. Finally, ulcer patients exhibited significantly more emotional distress in the form of depression and anxiety. Hypochondriasis, a negative perception of their life events, dependency, and lowered ego strength were the four variables that best discriminated ulcer patients from controls. This controlled study demonstrates a strong association between life events stress, psychosocial factors, and peptic ulcer disease.

In a comparison of 51 women suffering from biliary calculi and 74 women chosen at random by means of T-tests in GT, FAF and FPI, significant differences occurred in various scales. The test group differed from the control group in respect to aggressiveness, propensity toward depression and emotional instability. The test subjects suffering from biliary calculi were also given a 16 PF as well as a questionnaire on afflictions and risk factors, obesity dominating among the latter. With the help of discriminant analysis four-fifth of the participants could be correctly associated with their group. A conclusion concerning psychosomatic and psychodynamic correlations could only be reached by means of comparison with a psychoanalytical study.