Improvement in the quality of life following cholecystectomy: a randomized multicenter study of health status (RAND-36) in patients with laparoscopic cholecystectomy versus minilaparotomy cholecystectomy

• Published in: Quality of life research 2017-03, Vol.26 (3), p.665-671
• Main Authors: Aspinen, Samuli, Kärkkäinen, Jari, Harju, Jukka, Juvonen, Petri, Kokki, Hannu, Eskelinen, Matti
• Format: Article
• Language: English
• Subjects: Abdomen; Cholecystectomy; Cholecystectomy, Laparoscopic; Cholecystolithiasis - psychology; Cholecystolithiasis - surgery; CLINICAL AND POLICY APPLICATIONS; Comparative studies; Dissection; Female; Finland; Gallstones; Health; Health surveys; Hospitals; Humans; Laparoscopy; Male; Medicine; Medicine & Public Health; Mental health; Middle Aged; Minimally Invasive Surgical Procedures; Pain; Patient satisfaction; Perceptions; Postoperative Complications - psychology; Prospective Studies; Public Health; Quality of Life; Quality of Life Research; Questionnaires; Sociology; Surgery; Surgical techniques; Surveys and Questionnaires; Treatment Outcome; Ultrasonic imaging; Variance analysis
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-016-1485-1

Purpose The assessment of the quality of life (QoL) in minilaparotomy cholecystectomy (MC) versus laparoscopie cholecystectomy (LC) with the ultrasonic dissection in both groups has not been addressed earlier. Methods Initially, 109 patients with non-complicated symptomatic gallstone disease were randomized to undergo either MC (n = 59) or LC (n = 50). RAND-36 survey was conducted preoperatively and at 4 weeks and 6 months postoperatively. The end point of our study was to determine differences in health status in MC versus LC groups. Results QoL improved significantly in both groups, and the recovery was similar in the two groups, except from the higher score in 'health change' subscale at 4 weeks in MC group [MC score 75.0 (25.0) vs. LC score 56.5 (23.2), p = 0.008]. The MC and LC groups combined, RAND-36 scores increased significantly in 'physical functioning' [combined mean (SD) preoperative score 80.5 (23.9) vs. 6-month postoperative score 86.5 (21.7), p = 0.015], 'vitality' [64.5 (19.2) vs. 73.5 (18.3), p = 0.001], 'health change' [43.0 (21.6) vs. 74.6 (25.4), p = 0.0001] and 'bodily pain' scores [57.7 (26.3) vs. 75.5 (25.5), p = 0.001], respectively. Four RAND-36 domains indicated statistically significant health status differences in comparing the preoperative and postoperative RAND-36 scores in LC and MC groups combined. Conclusions Four RAND-36 domains indicated a significant positive change in QoL after cholecystectomy.