Long-term patient-reported outcomes following laparoscopic cholecystectomy

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.

Patient-reported outcome measures (PROMs) after laparoscopic cholecystectomy: systematic review

“…There was significant variation in the PROM tools used. A total of eight different comprehensive PROM tools were used, including: gastrointestinal QoL index (GIQLI) 18–23 , Short Form 36 (SF-36 ® , RAND Corporation, Santa Monica, CA, USA) 19 , 24–28 , SF-12 29–31 , World Health Organization QoL (WHOQoL)-BREF 32 , 33 , surgical outcomes measurement system (SOMS) 34 , 35 , euro quality of life (EQ-VAS) 36 , 37 , and PRO measurement information system (PROMIS)-10 38 . The most frequently used PROMs were the GIQLI (6 of 21) and the SF-36 ® (6 of 21).…”

“…Two studies did not report patients lost to follow-up. In 18 studies, the PROMs were completed by the patients alone, in 1 study the patients completed the PROM along with a nurse 18 , and in 1 study the patients completed the PROM along with a dedicated research coordinator 34 . One study did not report who completed the PROM 19 .…”

“…Four authors chose a PROM because it was validated in their language, and seven selected a tool because it has been validated previously. Three studies chose the GIQLI as it had been previously validated in patients undergoing LC or gallbladder surgery 18 , 19 , 22 .…”

“…The GIQLI survey score ranges from 0 to 144 with a higher number indicating a better QoL 50 . It has the advantage of including questions on specific gastrointestinal symptoms such as diarrhoea and has been recommended for use in patients undergoing LC by the European Association for Endoscopic Surgery 18 . It has disadvantages; it is only available in paper version, and the 36 questions take 15 to 20 min to complete.…”

Acupuncture therapy strategy options in postoperative management after laparoscopic cholecystectomy

“…[ 5 , 6 ] Nevertheless, POP may still occur and afflict patient in postoperative 1 month after LC, with the cost-effectiveness less than satisfactory. [ 7 ] In particularly, only one-third of patients can benefit from prophylactic antiemetics and PONV within 24 hours still occurs in 25% to 30% of patients. [ 8 , 9 ] In addition, other adverse effects like respiratory depression, gastrointestinal ulceration, headache, and malignant ventricular arrhythmias, have triggered growing concern.…”