Last modified: 2022-09-20
Abstract
Introduction: Choledochal cysts (CDC) are rare conditions affecting the biliary tree. While medical outcomes for CDC excision are well reported, quality of life outcomes are sparse.
Objectives: To study the long-term outcomes and HRQoL in patients operated for CDC.
Methods: Data of the patients from April 2014-June 2021 were included. HRQoL assessment was performed at a single point of time at a minimum of 6 months after surgery. SF-36 Proforma was administered by the primary investigator via direct/telephonic interview.
Results: Of the 44 cases of CDC, 36 patients were available to study the SF-36 HRQoL score. The mean age of patients was 51.3 years. Sixteen (36%) patients were more than 60 years of age; 18 (40.9%) had undergone endoscopic retrograde cholangiography (ERC) pre-operatively. All patients underwent CDC excision with RYHJ with good surgical outcomes (McDonald’s A&B) on long-term follow up. Major complications following surgery occurred only in 2 (4.5 %) patients, but it had significant bearing on several HRQoL domains on follow up. While age did not significantly affect HRQoL, there seemed to be a favorable HRQoL in physical functioning, pain and general health status domains for male patients; History of previous ERC intervention had a significant adverse effect on emotional well-being scale. Scores did not vary significantly based on time elapsed from surgery, suggesting that after a period of 6 months, most patients settle into comfortable lifestyles.
Conclusions: This is the first Indian study and one of the few in the world addressing QoL. This study shows that overall HRQoL outcomes at a minimum of 6 months following surgery are good in all domains of the SF-36 tool. Patient gender, history of ERC preceding surgery and major post-operative surgical complications affect various domains of HRQoL negatively.