Gastrointestinal quality of life in patients with symptomatic or asymptomatic cholelithiasis before and after laparoscopic cholecystectomy

Background: There is an ongoing need, from both the medical and the economi c perspective, for a more accurate definition of the influence of symptomat ic or asymptomatic gallstone disease on gastrointestinal symptomatology, as well as on the health of the individual in general. Methods: Using the Gastrointestinal Quality of Life Index (GIQLI), 37 sympt omatic and 30 asymptomatic gallstone patients were evaluated at admission t o the hospital and again 4 months after undergoing an uneventful laparoscop ic cholecystectomy (LC). Results: Postoperatively, significant increases in the total GIQLI score we re noted in both the symptomatic group (113.42 +/- 21.9 vs 80.32 +/- 19.1 p reoperatively, p<0.05) and the asymptomatic group (96.37<plus/minus>14.26 v s 113.30 +/- 15.22; p<0.05). For the subgroups of items, the core symptoms and the physical, psychological, and disease-specific items improved signif icantly in both groups in the postoperative period (p<0.05 for all comparis ons), but only the symptomatic group achieved a significant improvement in the subgroup of social items (p<0.05). Negative correlations were found in both the symptomatic and asymptomatic groups between the preoperative GIQLI scores and the improvement seen after LC (r=-0.70 and r=-0.49, respectivel y). Conclusion: Gallstone disease has a profoundly negative impact on quality o f life, especially in symptomatic patients with a history of biliary colic attacks and/or the complications of the disease. Although the condition is not equally distressing for the asymptomatic group of patients without such a history, uncomplicated LC improves the quality of life significantly in both groups. Gallstone patients with lower GIQLI scores are more likely to benefit from LC.