title: Gastrointestinal quality-of-life after cholecystectomy: indication predicts gastrointestinal symptoms and abdominal pain.
abstract: BACKGROUND
  Despite the fact that cholecystectomy is a common surgical procedure, the impact on long-term gastrointestinal quality of life is not fully known.
  
  
  METHODS
  All surgical procedures for gallstone disease performed at Mora County Hospital, Sweden, between 2 January 2002 and 2 January 2005, were registered on a standard database form. In 2007, all patients under the age of 80 years at follow-up were requested to fill in a form containing the Gastrointestinal Quality-of-Life Index (GIQLI) questionnaire and a number of additional questions. The outcome was analysed with respect to age, gender, smoking, surgical technique, and original indication for cholecystectomy.
  
  
  RESULTS
  A total of 627 patients (447 women, 180 men) underwent cholecystectomy, including laparoscopic cholecystectomy (N = 524), laparoscopic cholecystectomy converted to open cholecystectomy (N = 43), and open cholecystectomy (N = 60). The mean time between cholecystectomy and follow-up with the questionnaire was 49 months. The participation rate was 79 %. Using multivariate analysis in the form of generalised linear modelling, the original indication for cholecystectomy in combination with gender (p = 0.0042) was found to predict the GIQLI score. Female gender in combination with biliary colic as indication for cholecystectomy correlated with low GIQLI scores. Female gender also correlated with a higher risk for pain in the right upper abdominal quadrant after cholecystectomy (p = 0.028).
  
  
  CONCLUSIONS
  We found the original indication for cholecystectomy, together with gender, to predict gastrointestinal symptoms and abdominal pain after cholecystectomy. Careful evaluation of symptoms is important before planning elective cholecystectomy.
authors.affiliation: Department of Surgery, Örebro University Hospital, Kirurgkliniken USÖ, 70185, Örebro, Sweden, wanjura@telia.com.
authors.forename: Viktor
authors.initials: V
authors.lastname: Wanjura
authors.forename: Patrik
authors.initials: P
authors.lastname: Lundström
authors.forename: Johanna
authors.initials: J
authors.lastname: Osterberg
authors.forename: Ib
authors.initials: I
authors.lastname: Rasmussen
authors.forename: Britt-Marie
authors.initials: BM
authors.lastname: Karlson
authors.forename: Gabriel
authors.initials: G
authors.lastname: Sandblom
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D000367:Age Factors; D000368:Aged; D002763:Cholecystectomy / Q000009:adverse effects / Q000379:methods; D002764:Cholecystitis / Q000150:complications / Q000601:surgery*; D042883:Choledocholithiasis / Q000150:complications / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology / Q000523:psychology; D003085:Colic / Q000150:complications / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000601:surgery; D017060:Patient Satisfaction; D011788:Quality of Life; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013548:Sweden