Improvement in the quality of life following cholecystectomy: a randomized multicenter study of health status (RAND-36) in patients with laparoscopic cholecystectomy versus minilaparotomy cholecystectomy.

Abstract

The assessment of the quality of life (QoL) in minilaparotomy cholecystectomy (MC) versus laparoscopic cholecystectomy (LC) with the ultrasonic dissection in both groups has not been addressed earlier. Initially, 109 patients with non-complicated symptomatic gallstone disease were randomized to undergo either MC (n=59) or LC (n=50). RAND-36 survey was conducted preoperatively and at 4weeks and 6months postoperatively. The end point of our study was to determine differences in health status in MC versus LC groups. QoL improved significantly in both groups, and the recovery was similar in the two groups, except from the higher score in 'health change' subscale at 4weeks in MC group [MC score 75.0 (25.0) vs. LC score 56.5 (23.2), p=0.008]. The MC and LC groups combined, RAND-36 scores increased significantly in 'physical functioning' [combined mean (SD) preoperative score 80.5 (23.9) vs. 6-month postoperative score 86.5 (21.7), p=0.015], 'vitality' [64.5 (19.2) vs. 73.5 (18.3), p=0.001], 'health change' [43.0 (21.6) vs. 74.6 (25.4), p=0.0001] and 'bodily pain' scores [57.7 (26.3) vs. 75.5 (25.5), p=0.001], respectively. Four RAND-36 domains indicated statistically significant health status differences in comparing the preoperative and postoperative RAND-36 scores in LC and MC groups combined. Four RAND-36 domains indicated a significant positive change in QoL after cholecystectomy.