title: Patient-reported outcomes of symptomatic cholelithiasis patients following cholecystectomy after at least 5 years of follow-up: a long-term prospective cohort study.
abstract: BACKGROUND
  Up to 41% of patients report pain after cholecystectomy and in most studies follow-up for these symptoms did not exceed 5 years. The episodic nature of abdominal pain associated with symptomatic cholelithiasis warrants long-term follow-up studies. We assessed which patient and surgical factors were associated with absence of pain and patient-reported success of surgery after ≥ 5 years of follow-up.
  
  
  METHODS
  Patients of ≥ 18 years of age with symptomatic cholelithiasis, classified as ASA I or II, who had previously returned a preoperative questionnaire were sent a questionnaire consisting of the gastrointestinal quality of life index (GIQLI) and patient ratings of current versus presurgical abdominal symptoms and of surgery result. Logistic regression analysis was performed to determine associations.
  
  
  RESULTS
  Questionnaires were sent to 197 patients and returned by 126 (64.0%) patients (73.8 % female, mean age at surgery 47.5 ± 12.2 years) at a mean of 10.0 ± 1.0 years after cholecystectomy. Absence of abdominal pain was reported by 60.3% of the patients. Patients classified as ASA II as opposed to ASA I were less likely to report absence of pain (OR 0.41, 95% CI 0.17-0.99). A positive rating of long-term postsurgical versus presurgical abdominal symptoms was given by 89.7% of the patients and 90.5% considered the cholecystectomy result to be good. No variables were significantly associated with these latter two outcome measures.
  
  
  CONCLUSIONS
  We found a high patient-reported surgery success rate after >5 years of follow-up after cholecystectomy despite residual abdominal pain in some of these patients. None of the patient and surgery-related characteristics were consistently associated with all three outcome measures. This discrepancy between patient' outcomes highlights the need for realistic expectations prior to cholecystectomy.
authors.affiliation: Department of Gastroenterology and Hepatology, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands, Marklamberts@hotmail.com.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Lamberts
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Den Oudsten
authors.forename: Frederik
authors.initials: F
authors.lastname: Keus
authors.forename: Jolanda
authors.initials: J
authors.lastname: De Vries
authors.forename: Cornelis J H M
authors.initials: CJ
authors.lastname: van Laarhoven
authors.forename: Gert P
authors.initials: GP
authors.lastname: Westert
authors.forename: Joost P H
authors.initials: JP
authors.lastname: Drenth
authors.forename: Jan A
authors.initials: JA
authors.lastname: Roukema
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology*; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011184:Postoperative Period; D011446:Prospective Studies; D012008:Recurrence; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome