Patient-Reported Pain and Quality of Life Outcomes Following Iatrogenic Gallbladder Perforation During Laparoscopic Cholecystectomy.

Abstract

Objectives: Intraoperative gallbladder perforation (IGP) is a frequent adverse event in laparoscopic cholecystectomy; however, its influence on patient-reported pain and health-related quality of life (HRQoL) is underinvestigated. This research evaluated the level of postoperative pain and HRQoL in patients with and without IGP.

Materials design: A longitudinal observational study was conducted on 300 adults who underwent elective laparoscopic cholecystectomy.

Methods: The Brief Pain Inventory-Short Form (BPI-SF) and EQ-5D-5L assessed pain and HRQoL at 1 point in time (baseline) and at 2 points in time (3 and 6 months). Pearson's chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and general linear models were used as statistical tests.

Results: IGP was present in 80% of participants and was significantly associated with increased pain (r = 0.25, p < 0.001) and reduced HRQoL (r = -0.20, p < 0.001). HRQoL showed a moderate negative correlation with pain (r = -0.35, p = 0.001). Females complained about more pain and reduced QoL (p < 0.001). The IGP group also scored more in BPI-SF (baseline: 64.5 vs. 55.3; 6 months: 58.1 vs. 48.0) and continued to score lower in EQ-5D-5L. Even though pain and HRQoL improved over time, the difference between the IGP and non-IGP groups was substantial.

Conclusion: Iatrogenic gallbladder perforation results in postoperative pain and a decrease in HRQoL that persisted up to six months postoperative. The use of preventive surgery and specific postoperative management is mandatory to enhance patient outcomes.