Comparative quality of life study between endoscopic sphincterotomy and surgical choledochotomy

AIM: To determine quality of life improvement in choledocholithiasis patients who underwent endoscopic sphincterotomy(EST) versus open choledochotomy(OCT).METHODS: Eligible choledocholithiasis patients(n = 216) hospitalized in the Changhai Hospital between May 2010 and January 2011 were enrolled into a prospective study using cluster sampling. Patients underwent EST(n = 135) or OCT(n = 81) depending on the patient's wishes. Patients were followed-up with a field survey and by correspondence. Patients were also given the self-administered Gastrointestinal Quality of Life Index(GIQLI) to measure patient quality of life before surgery, and at two and six weeks after the procedures.RESULTS: With respect to baseline patient character-istics, the EST and OCT groups were comparable. After the procedure, gallstones were completely eliminated in all patients. Among 216 eligible patients, 191 patients(88.4%) completed all three surveys, including 118 patients who underwent EST(118/135; 87.4%) and 73 patients who underwent OCT(73/81; 90.1%). EST was associated with a significantly shorter hospital stay than OCT(8.8 ± 6.5 vs 13.9 ± 6.7 d; P < 0.001). The GIQLI score was similar between the EST and OCT groups before cholelithotomy(103.0 ± 15.4 vs 99.7 ± 10.2), but increased significantly in the EST group at two weeks(113.4 ± 12.0 vs 107.2 ± 11.2; P < 0.001) and six weeks(120.7 ± 10.6 vs 116.9 ± 7.5; P < 0.05) after the procedures.CONCLUSION: EST, compared with OCT, is associated with better postoperative quality of life in patients treated for choledocholithiasis.