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

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.