Patient-centered outcomes after laparoscopic cholecystectomy

Matthew Zapf*, Woody Denham, Ermilo Barrera, Zeeshan Butt, Joann Carbray, Chih Wang, John Linn, Michael Ujiki

*Corresponding author for this work

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Background: Laparoscopic cholecystectomy (LC) is the second most common general surgical operation performed in the United States, yet little has been reported on patient-centered outcomes. Methods: We prospectively followed 100 patients for 2 years as part of an institutional review board-approved study. The Surgical Outcomes Measurement System (SOMS) was used to quantify quality-of-life (QoL) values at various time points postoperatively. Results: Maximum pain was reported at 24 h (5.5 ± 2.2), and decreased to preoperative levels at 7 days (1.2 ± 2.3 vs. 2.0 ± 1.6, P = 0.096). Bowel function improved from before the operation to 3 weeks after surgery (10.7 ± 3.8 vs. 12.0 ± 3.2, P < 0.05), but then regressed to preoperative levels. Physical function worsened from before surgery (31.7 ± 6.2) to 1 week (27.5 ± 5.9, P < 0.0001), but surpassed preoperative levels at 3 weeks (33.5 ± 3.4, P < 0.01). Return to the activities of daily living occurred at 6.3 ± 4.7 days and work at 11.1 ± 9.0 days. Fatigue increased from before surgery (15.8 ± 6.2) to week 1 (20.7 ± 6.6, P < 0.0001) before improving at week 3 (14.0 ± 5.8, P < 0.01). Forty-four patients contacted the health care team 61 times before their 3 weeks appointment, most commonly for wound issues (26.2 %), pain (24.6 %), and gastrointestinal issues (24.6 %). Seventy-two percent reported that the procedure had no negative effect on cosmesis at 6 months. Satisfaction with the procedure was high, averaging 9.52 out of 11. Conclusions: QoL is significantly affected in the 24 h after LC but returns to baseline at week 3. Cosmesis and overall satisfaction are high, and QoL improvements are maintained in the long term except for bowel function, which regresses to preoperative levels of impairment. Analysis of patient-initiated contacts after LC may provide feedback on discharge counseling to increase patient satisfaction.

Original languageEnglish (US)
Pages (from-to)4491-4498
Number of pages8
JournalSurgical endoscopy
Volume27
Issue number12
DOIs
StatePublished - Jan 1 2013

Keywords

  • Cholecystectomy
  • Complications
  • Gallbladder
  • Pain
  • Quality of life

ASJC Scopus subject areas

  • Surgery

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    Zapf, M., Denham, W., Barrera, E., Butt, Z., Carbray, J., Wang, C., Linn, J., & Ujiki, M. (2013). Patient-centered outcomes after laparoscopic cholecystectomy. Surgical endoscopy, 27(12), 4491-4498. https://doi.org/10.1007/s00464-013-3095-0