Episodic abdominal pain characteristics are not associated with clinically relevant improvement of health status after cholecystectomy

Mark P Lamberts, Wietske Kievit, Jos J G M Gerritsen, J.A. Roukema, Gert P Westert, Joost P H Drenth, Cornelis J H M van Laarhoven

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Abstract

Background: 

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.

Methods: 

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.

Results: 

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.

Conclusions: 

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.

Original languageEnglish
Pages (from-to)1350–1358
JournalJournal of Gastrointestinal Surgery
Volume20
Issue number7
DOIs
Publication statusPublished - 2016

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Multicenter Studies
Logistic Models
Interviews
Surveys and Questionnaires

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Lamberts, Mark P ; Kievit, Wietske ; Gerritsen, Jos J G M ; Roukema, J.A. ; Westert, Gert P ; Drenth, Joost P H ; van Laarhoven, Cornelis J H M. / Episodic abdominal pain characteristics are not associated with clinically relevant improvement of health status after cholecystectomy. In: Journal of Gastrointestinal Surgery. 2016 ; Vol. 20, No. 7. pp. 1350–1358.
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abstract = "Background: 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.Methods: 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.Results: 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.Conclusions: 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.",
author = "Lamberts, {Mark P} and Wietske Kievit and Gerritsen, {Jos J G M} and J.A. Roukema and Westert, {Gert P} and Drenth, {Joost P H} and {van Laarhoven}, {Cornelis J H M}",
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Episodic abdominal pain characteristics are not associated with clinically relevant improvement of health status after cholecystectomy. / Lamberts, Mark P; Kievit, Wietske; Gerritsen, Jos J G M; Roukema, J.A.; Westert, Gert P; Drenth, Joost P H; van Laarhoven, Cornelis J H M.

In: Journal of Gastrointestinal Surgery, Vol. 20, No. 7, 2016, p. 1350–1358.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Episodic abdominal pain characteristics are not associated with clinically relevant improvement of health status after cholecystectomy

AU - Lamberts, Mark P

AU - Kievit, Wietske

AU - Gerritsen, Jos J G M

AU - Roukema, J.A.

AU - Westert, Gert P

AU - Drenth, Joost P H

AU - van Laarhoven, Cornelis J H M

N1 - Geen affiliatie met TiU. Affiliatie EZ

PY - 2016

Y1 - 2016

N2 - Background: 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.Methods: 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.Results: 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.Conclusions: 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.

AB - Background: 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.Methods: 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.Results: 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.Conclusions: 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.

U2 - 10.1007/s11605-016-3156-5

DO - 10.1007/s11605-016-3156-5

M3 - Article

C2 - 27188580

VL - 20

SP - 1350

EP - 1358

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 7

ER -