| Summary: | 碩士 === 高雄醫學大學 === 醫務管理學研究所碩士在職專班 === 97 === The cholecystectomy can be divided into open cholecystectomy (OC) and laparoscopic cholecystectomy (LC). There are many international studies abroad comparing open medical procedures with traditional medical procedures, which supports superior benefits in the early postoperative stage of LC; but there are limited studies comparing the quality of life during the follow-up period between these two techniques in Taiwan. The study compared these two cholecystectomy techniques during the short follow-up period, and evaluated the quality of life and clinical results of patients.
We evaluated 297 patients (OC: 38, LC: 259) conducting cholecystectomy in two medical centers between February 13, 2007 and November 20, 2007. We explored the improvement between different dimensions of assessment tools such as Gastrointestinal Quality of Life Index (GIQLI) and Global Taiwan SF-36 Questionnaire by repeated measures of GEE, effect size, bootstrapping and MCID, to investigate the improvement tendency of outcomes and the related risk factors.
Not only the improvement tendency of HRQoL between 3 and 6 months post-operation of LC showed significant positive correlation (p < 0.001), but also the improvement tendency of HRQoL between 3 and 6 months post-operation of OC (p < 0.001), except for the social function. Among GIQLI items, the effect sizes of four anchor items in the mild improvement group (0.38-0.49) were higher than the similiar group (0.25-0.38), which demostrated the usage and interpretation values of MCID. Furthermore, the difference of age has significant influence on the HRQoL improvement after cholecystectomy (p<0.05).
We could find evidence supporting superior short term quality of life for LC in
both GIQLI and SF-36. The responsiveness estimation of ES suggested that the efficacy estimation of GIQLI was higher than SF-36 in general, with much better disease-specific measures, which could provide outcome measures for clinical sfaff and health professionals. Among the characteristics of patient, age has important and independent effect on QoL outcomes. Besides, the pre-operative function status was also very important to the post-operation HQRoL improvement.
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