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QUALITY OF LIFE AFTER LAPAROSCOPIC CHOLECYSTECTOMY: A PROSPECTIVE STUDY
Navin D. Bhatia^*, Caitlyn Braschi, Amy J. Garvey, Jeffrey J. Aalberg, Celia M. Divino
Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
Background: Laparoscopic cholecystectomy is among the most commonly performed abdominal surgeries in the United States. Although postoperative pain and diarrhea have been reported, little is known about the overall effect of this surgery on quality of life. This study aimed to evaluate the impact of outpatient laparoscopic cholecystectomy on patients' long-term quality of life.

Methods: 106 patients undergoing elective laparoscopic cholecystectomy were prospectively enrolled over an 18-month period from 2016 to 2017. Questionnaires were distributed to patients at three time points: the preoperative visit, one month postoperatively, and six months postoperatively. The validated 12-Item Short Form Health Survey (SF12) was used to generate composite measures of physical health, mental health, and social functioning. A second survey was created to gauge procedure-specific health measures including occurrence and intensity of pain as well as frequency of bowel movements and diarrhea. Mixed-model regression analysis was used to evaluate changes in symptoms over time, adjusted for BMI, history of GERD, indications for surgery, and prior abdominal surgeries.

Results: As measured by the SF12 aggregate, overall physical health remained unchanged at one month postoperatively but improved by 3.7 points at six months (p = 0.0051). Additionally, there was a 1.7 point increase in emotional well-being and 5.7 point increase in social functioning at the second follow-up (p = 0.0169 and p = 0.0007 respectively). Severity of pain decreased by 1.2 points at one month and by 1.7 points at six months (p < 0.0001). Similarly, pain frequency decreased by 1.2 and 1.9 points at the initial and final postoperative assessments (p <0.0001). Daily episodes of diarrhea were unchanged at the first follow-up and decreased by 0.34 at six months (p = 0.0293). There was no significant change in number of daily bowel movements at either time point.

Conclusion: Patients reported long-term improvement in physical and mental health after elective laparoscopic cholecystectomy. Pain frequency and severity as well as episodes of diarrhea were found to decrease during this time period. These data underscore important quality of life measures providers may utilize when discussing the risks and benefits of elective laparoscopic cholecystectomy with patients.

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