Long-term patient-reported outcomes following laparoscopic cholecystectomy: A prospective multicenter observational study

Medicine (Baltimore). 2020 Aug 28;99(35):e21683. doi: 10.1097/MD.0000000000021683.

Abstract

Several studies have reported short-term results for post-cholecystectomy symptoms and quality of life (QoL). However, reports on long-term results are still limited. This study aimed to identify risk factors affecting short- and long-term patient-reported outcome (PRO) following laparoscopic cholecystectomy.From 2016 to 2017, a total of 476 patients from 5 institutions were enrolled. PRO was examined using the Numeric Rating Scale (NRS) pain score and the Gastrointestinal (GI) QoL Index questionnaire at postoperative 1 month and 1 year.Most of patients recovered well at postoperative 1 year compared to postoperative 1 month for the NRS pain score, QoL score, and GI symptoms. A high operative difficulty score (HR 1.740, P = .031) and pathology of acute or complicated cholecystitis (HR 1.524, P = .048) were identified as independent risk factors for high NRS pain scores at postoperative 1 month. Similarly, female sex (HR 1.571, P = .003) at postoperative 1 month and postoperative complications (HR 5.567, P = .001) at postoperative 1 year were independent risk factors for a low QoL. Also, age above 50 (HR 1.842, P = .001), female sex (HR 1.531, P = .006), and preoperative gallbladder drainage (HR 3.086, P = .001) were identified as independent risk factors for GI symptoms at postoperative 1 month.Most patients showed improved long-term PRO measurement in terms of pain, QoL, and GI symptoms. There were no independent risk factors for long-term postoperative pain and GI symptoms. However, postoperative complications were identified to affect QoL adversely at postoperative 1 year. Careful and long-term follow up is thus necessary for patients who experienced postoperative complications.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Age Factors
  • Cholecystectomy, Laparoscopic* / adverse effects
  • Cholecystitis / complications
  • Cholecystitis / surgery
  • Drainage
  • Female
  • Gallbladder Diseases / surgery*
  • Gastrointestinal Diseases / etiology*
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Patient Reported Outcome Measures
  • Postoperative Pain / etiology*
  • Postoperative Period
  • Preoperative Care
  • Prospective Studies
  • Quality of Life*
  • Risk Factors
  • Sex Factors
  • Surveys and Questionnaires
  • Time Factors