Quality-of-life after cholecystectomy in Kazakhstan and Sweden: comparative study based on the GIQLI questionnaire.

Abstract Background As severe morbidity rarely is the focus in gallstone surgery, health-related quality of life has evolved as the main outcome measure of the management of patients with gallstone disease. The lack of universally accepted guidelines on treatment of gallstone disease has also resulted in great regional differences in the preoperative evaluation and management of patients with gallstone disease. Objective The aim of this study was to compare quality-of-life following gallstone surgery in cohorts from Kazakhstan and Sweden. Methods A comparative study on quality-of-life (QoL) after cholecystectomy (CE) in two cohorts from Sweden and Kazakhstan using the Gastrointestinal Quality-of-Life Index (GIQLI) questionnaire. QoL measures of 259 patients in Kazakhstan and 448 patients in Sweden were compared taking into account surgical approach, mode of admission, and indication for surgery. Patients in both cohorts were requested to fill in the GIQLI questionnaire after surgery. Similar routines were applied to ensure high coverage in both countries. Results The mean overall GIQLI score was higher for patients undergoing cholecystectomy in Sweden than those in Kazakhstan (p < 0.01). The same was seen when stratifying for open or laparoscopic surgery (both p < 0.05), absence of presence of acute cholecystitis (both p < 0.05) and emergency admission (p < 0.05), but not in case of planned admission (p = 0.54). Conclusions There were large differences in perceived QoL, even when taking indication for surgery and approach into account. These differences in may be explained by differences in attitudes to health status and treatment expectations. Standardized routines for evaluating the outcome after surgery are needed.