Long-term detrimental effect of bile duct injury on health-related quality of life

Hypothesis: Long-term quality of life (QOL) in patients undergoing laparoscopic cholecystectomy (LC) incurring bile duct injury (BDI) and repair is comparable to that of patients undergoing uncomplicated LC. Design: Case comparison study. Setting: Secondary and tertiary care centers Patients: Eighty-six patients incurring BDI during LC between January 1, 199 1, and July 31, 2003, were surveyed. Comparison subjects underwent uncomplicated LC during the same period. Main Outcome Measures: Health-related QOL as assessed by the Karnofsky Performance Scale, Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), and Psychosocial Adjustment to Illness Scale. Results: Fifty patients with BDI (39 [78%] female;, mean +/- SEM age, 55 +/- 2 years) and 74 patients with uncomplicated LC (51 [69%] female, mean +/- SEM age, 52 +/- 2 years) responded. Of the 50 BDI patients, 48 (96%) had no stricture and normal liver function at QOL assess-ment. The mean +/- SEM follow-up period to QOL assess-ment for the BDI and uncomplicated LC groups was 62 +/- 6 and 47 +/- 3 months, respectively. The mean +/- SD Karnofsky Performance Scale scores were 77 +/- 9 vs 93 +/- 8 for the 2 groups, respectively (P<.001). The mean ± SD SF-36 physical component scale scores after BDI vs uncomplicated LC were 36 ± 11 vs 47 ± 12, respectively (P<.001), compared with 50 +/- 10 for the normal population (P<.001). The mean SD SF-36 mental component scale scores were 43 ± 14 vs 49 ± 11 for the 2 groups, respectively (P =. 02), compared with 50 ± 10 for the normal population (P =.01). Patients with BDI scored poorer on the Psychosocial Adjustment to Illness Scale health care orientation and domestic environment scales (P=.01). Conclusion: After BDI and repair, there are long-term detrimental effects of BDI on health-related QOL.