%0 Journal Article
%T Patient-reported outcomes following subtotal cholecystectomy: results from a cross-sectional survey of 71 patients operated on between 2012 and 2021
%A Lunevicius, Raimundas
%A Bennett, Jack F.
%A Nzenwa, Ikemsinachi C.
%J AME Surgical Journal
%D 2026
%B 2026
%9 
%! Patient-reported outcomes following subtotal cholecystectomy: results from a cross-sectional survey of 71 patients operated on between 2012 and 2021
%K 
%X Background: Subtotal cholecystectomy (STC) is undertaken as a damage-control procedure when complete gallbladder removal would confer substantial operative risk. Despite its increasing use, long-term patient-reported outcome measures (PROMs) following STC remain insufficiently characterised. In this study, we aimed to evaluate long-term PROMs after STC and examine associations between perioperative variables and PROM scores.Methods: We identified 226 adults who underwent STC at Aintree University Hospital, Liverpool, between 1 January 2011 and 31 December 2021 as potential interviewees for a semi-structured telephone interview in May 2023. Data on basic demographics, preoperative patient-related factors, and STC-specific perioperative information were extracted from databases used for other studies evaluating STC clinical outcomes. A five-section questionnaire incorporating validated instruments [Gastrointestinal Quality of Life Index-10 (GIQLI-10) and General Health and Health Change domains of the Short Form-36 (SF-36)] and a single-item health self-assessment (HSA) score was administered. Spearman’s rank-order correlation coefficient was used to assess associations between quality of life (QoL) measures. Associations between PROMs and perioperative variables were assessed using the Mann-Whitney U and the Kruskal-Wallis tests, as applicable; considering the multiple tests conducted, the Bonferroni correction was applied.Results: Seventy-one patients aged 28–82 years who underwent STC between 2012 and 2021 completed the interview. Forty-one were female. The median interval between STC and survey was 6.7 years [interquartile range (IQR), 5–8.1 years]. The mean GIQLI-10 score was 31.7±7.0 (median 33, IQR, 28–37), equivalent to 82.5% of the maximum. The most frequently reported symptoms, which persist most or all of the time, were fatigue (21, 29.6%), bloating (15, 21.1%), flatulence (14, 19.7%), dietary restrictions (9, 12.7%), abdominal pain (12.7%), diarrhoea (12.7%), constipation (9, 12.7%), nausea (6, 8.5%), belching (5, 7.0%), and blood in stool (1, 1.4%). Based on the SF-36 General Health question, 63.4% of the patients rated their health as excellent, very good, or good. The mean HSA score was 67.9±20.1 (median 70, IQR, 50–80). No significant associations were observed between perioperative variables [emergent vs. planned surgery, laparoscopic vs. open surgery, STC variants (STC-1, -2, -3, -4), STC completion type (fenestrating vs. reconstituting), Clavien-Dindo grade, bile duct injury, bile leak, surgical site infection, readmission, post-STC endoscopic retrograde cholangiopancreatography (ERCP), incisional hernia] and PROMs.Conclusions: At a mean follow-up of nearly 7 years, patients who underwent STC reported acceptable gastrointestinal health and overall well-being. These findings support STC as a safe and durable management strategy for complex gallstone disease when total cholecystectomy (TC) is not feasible.
%U https://asj.amegroups.org/article/view/124325
%V 6
%P 
%@ 2788-578X