SP 7.17 Postoperative Outcomes and Quality of Life After Post-Cholecystectomy Bile Duct Injury: A Systematic Review and Meta-Analysis

Aim

To compare quality of life (QoL) outcomes among patients who sustained bile duct injury (BDI) during laparoscopic cholecystectomy in addition to those who had an uncomplicated laparoscopic cholecystectomy.

Methods

A systematic search and screening of literature was conducted resulting in 19 studies that reported QoL outcomes following BDI were. 13 studies assessed QoL using Short form 36 (SF-36), of which 5 incorporated uncomplicated laparoscopic cholecystectomy control groups and used for meta-analysis. Analysis was performed using random-effects models, calculating mean differences (MD) with 95% CI. Statistical heterogeneity was assessed using the I2 statistic.

Results

The 19 studies Individual study sample sizes ranged from 19 to 800 patients, with a consistent female predominance (65-70%) and mean ages ranging from 40-57 years.

Meta-analysis demonstrated significantly poorer QoL in BDI patients across all 8 SF-36 domains compared with controls. Compared to physical outcomes, there were significant impairments reported in mental health domains including emotional health (MD -29.48 95% Cl -49.06, -9.91) and social functioning (MD -16.82, 95% CI -27.92, -5.71). Physical limitations, vitality, general health perception and bodily pain were also reduced. Substantial heterogeneity was present across domains (I2 72-92%), reflecting the clinical and methodological variability.

Conclusion

BDI following laparoscopic cholecystectomy is associated with impairments to quality of life which extend beyond physical morbidity. Significant reductions to social and emotional functioning were reported following BDI. These findings show the need for mental health support, improved patient counselling, and greater emphasis on QoL as a key outcome in BDI management and research.