title: Prospective multicentre cohort study of patient-reported outcomes after cholecystectomy for uncomplicated symptomatic cholecystolithiasis.
abstract: BACKGROUND
  Up to 33 per cent of patients with uncomplicated symptomatic cholecystolithiasis report persistent pain after cholecystectomy. The aim of this study was to determine characteristics associated with patient-reported absence of abdominal pain after cholecystectomy, improved abdominal symptoms, and patient-reported positive cholecystectomy results in a prospective cohort multicentre study.
  
  
  METHODS
  Patients aged 18 years or more with symptomatic cholecystolithiasis who had a cholecystectomy between June 2012 and June 2014 in one of three hospitals were included. Before surgery all patients were sent the Gastrointestinal Quality of Life Index (GIQLI) questionnaire and the McGill Pain Questionnaire (MPQ). At 12 weeks after surgery, patients were invited to complete the GIQLI and Patients' Experience of Surgery Questionnaire (PESQ). Logistic regression analyses were performed to determine associations.
  
  
  RESULTS
  Questionnaires were sent to 552 patients and returned by 342 before and after surgery. Postoperative absence of abdominal pain was reported by 60·5 per cent of patients. A high preoperative GIQLI score, episodic pain, and duration of pain of 1 year or less were associated with postoperative absence of pain. These factors showed no association with improved abdominal symptoms (reported by 91·5 per cent of patients) or a positive surgery result (reported by 92·4 per cent).
  
  
  CONCLUSIONS
  Preoperative characteristics determine the odds for relief of abdominal pain after cholecystectomy. However, these factors were not associated with patient-reported improvement of abdominal symptoms or patient-reported positive cholecystectomy results, highlighting the variation of internal standards and expectations of patients before cholecystectomy.
authors.affiliation: Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands.|Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands.|Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: Lamberts
authors.affiliation: Department of Medical and Clinical Psychology, Centre of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands.
authors.forename: B L
authors.initials: BL
authors.lastname: Den Oudsten
authors.affiliation: Department of Surgery, Medisch Spectrum Twente Hospital, Enschede, The Netherlands.
authors.forename: J J G M
authors.initials: JJ
authors.lastname: Gerritsen
authors.affiliation: Department of Surgery, St Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Roukema
authors.affiliation: Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands.
authors.forename: G P
authors.initials: GP
authors.lastname: Westert
authors.affiliation: Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: J P H
authors.initials: JP
authors.lastname: Drenth
authors.affiliation: Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: C J H M
authors.initials: CJ
authors.lastname: van Laarhoven
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D041761:Cholecystolithiasis / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology*; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult