title: Episodic Abdominal Pain Characteristics Are Not Associated with Clinically Relevant Improvement of Health Status After Cholecystectomy.
abstract: Cholecystectomy is the therapy of first choice in patients with uncomplicated symptomatic cholecystolithiasis, but it remains unclear which patients truly benefit in terms of health status improvement. Patients generally present with episodic abdominal pain of varying frequency, duration, and intensity. We assessed whether characteristics of abdominal pain episodes are determinants of clinically relevant improvement of health status after cholecystectomy.
  
  
  
  In a post hoc analysis of a prospective multicenter cohort study, patients of ≥18 years of age with uncomplicated symptomatic cholecystolithiasis subjected to cholecystectomy were included. Preoperatively, patients received a structured interview and a questionnaire consisting of the visual analogue scale (VAS; range 0-100) and gastrointestinal quality of life index (GIQLI). At 12 weeks after cholecystectomy, the GIQLI was again administered. Logistic regression analyses were performed to determine significant associations.
  
  
  
  Questionnaires were sent to 261 and returned by 166 (63.6 %) patients (128 females, mean age at surgery 49.5 ± 13.8). A total of 131 (78.9 %) patients reported a clinically relevant improvement of health status. The median (interquartile range) frequency, duration, and intensity of abdominal pain episodes were 0.38 (0.18-0.75) a week, 4.00 (2.00-8.00) hours, and 92 (77-99), respectively. None of the characteristics was associated with a clinically relevant improvement of health status at 12 weeks after cholecystectomy.
  
  
  
  Characteristics of abdominal pain episodes cannot be used to inform patients with symptomatic cholecystolithiasis who are skeptic about the timing of cholecystectomy for optimal benefit. Timing of cholecystectomy should therefore be based on other characteristics and preferences.
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. Marklamberts@hotmail.com.|Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands. Marklamberts@hotmail.com.|Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands. Marklamberts@hotmail.com.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Lamberts
authors.affiliation: Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Wietske
authors.initials: W
authors.lastname: Kievit
authors.affiliation: Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Jos J G M
authors.initials: JJ
authors.lastname: Gerritsen
authors.affiliation: Department of Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Roukema
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Gert P
authors.initials: GP
authors.lastname: Westert
authors.affiliation: Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Joost P H
authors.initials: JP
authors.lastname: Drenth
authors.affiliation: Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Cornelis J H M
authors.initials: CJ
authors.lastname: van Laarhoven
mesh_terms: D015746:Abdominal Pain / Q000209:etiology* / Q000601:surgery; D000328:Adult; D002763:Cholecystectomy; D041761:Cholecystolithiasis / Q000601:surgery*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Cholecystectomy; Health status; Pain