The long-term health-related quality of life in patients operated for choledochal cyst
Abstract
Purpose
Late postoperative complications in choledochal cyst (CC) patients are severe problems that affect the quality of life (QOL). We evaluated the postoperative complications and health-related QOL (HRQOL) of CC patients ≥ 18 years of age.
Methods
From April 1984 to January 2018, 114 CC patients underwent definitive surgery at our institution. Seventy-nine patients reached ≥ 18 years of age. The HRQOL was assessed using the Japanese version of the SF-36v2. Eight health domain (physical functioning, role-physical, body pain, general health, role-emotional, vitality, mental health, and social functioning) scores and three component summary [physical component summary, mental component summary (MCS), and role-social component summary] scores were compared between the patients with and without complications (C [+] vs. C [−]).
Results
Thirty-five patients answered the questionnaires. Twelve patients had postoperative complications. Among the eight domains, the score of general health was significantly lower in C [+] patients than in C [−] patients (p = 0.0488). Among the three component scores, the MCS score in C [+] patients was lower than in C [−] patients without significance (p = 0.0953).
Conclusions
The HRQOL of CC patients ≥ 18 years of age was mostly acceptable. However, postoperative complications can impair the sense of well-being and affect the mental health.
Keywords
Choledochal cyst Postoperative complication Health-related quality of life General health Mental healthNotes
Acknowledgements
We thank Mr. Brian Quinn for his comments and help with the manuscript. This study was supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS, nos. 26670765, 16K10466, 16K10094, 16K10095, 16K10434, 16H07090, 17K10555, 17K11514, 17K10183, 17K11515), a Research Grant from the President’s Discretionary Expenses of our University, a Research Grant from The UBE Foundation, a Research Grant from Kawano Masanori Memorial Public Interest Incorporated Foundation for Promotion of Pediatrics, Research Grant from Tateishi Science and Technology Foundation, a Research Grant from Mitsui Life Social Welfare Foundation, and a Research Grant from The Kurata Grants of the Hitachi Global Foundation. Sponsor of Manuscript Submission: Atsuyuki Yamataka, M.D., Ph.D., F.A.A.P. (Hon), Department of Pediatric Surgery, Juntendo University, Tokyo, Japan.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest in association with the present study.
References
- 1.Lipsett PA, Pitt HA (2003) Surgical treatment of choledochal cysts. J Hepatobiliary Pancreat Surg 10:352–359. https://doi.org/10.1007/s00534-002-0797-4 CrossRefGoogle Scholar
- 2.Todani T, Watanabe Y, Urushihara N, Noda T, Morotomi Y (1995) Biliary complications after excisional procedure for choledochal cyst. J Pediatr Surg 30:478–481CrossRefGoogle Scholar
- 3.Chijiiwa K, Tanaka M (1994) Late complications after excisional operation in patients with choledochal cyst. J Am Coll Surg 179:139–144Google Scholar
- 4.Saing H, Han H, Chan KL, Lam W, Chan FL, Cheng W, Tam PK (1997) Early and late results of excision of choledochal cysts. J Pediatr Surg 32:1563–1566CrossRefGoogle Scholar
- 5.Tsuchida Y, Takahashi A, Suzuki N, Kuroiwa M, Murai H, Toki F, Kawarasaki H, Hashizume K, Honna T (2002) Development of intrahepatic biliary stones after excision of choledochal cysts. J Pediatr Surg 37:165–167CrossRefGoogle Scholar
- 6.Ohashi T, Wakai T, Kubota M, Matsuda Y, Arai Y, Ohyama T, Nakaya K, Okuyama N, Sakata J, Shirai Y, Ajioka Y (2013) Risk of subsequent biliary malignancy in patients undergoing cyst excision for congenital choledochal cysts. J Gastroenterol Hepatol 28:243–247. https://doi.org/10.1111/j.1440-1746.2012.07260.x CrossRefGoogle Scholar
- 7.Ono S, Fumino S, Shimadera S, Iwai N (2010) Long-term outcomes after hepaticojejunostomy for choledochal cyst: a 10- to 27-year follow-up. J Pediatr Surg 45:376–378. https://doi.org/10.1016/j.jpedsurg.2009.10.078 CrossRefGoogle Scholar
- 8.Soares KC, Kim Y, Spolverato G, Maithel S, Bauer TW, Marques H, Sobral M, Knoblich M, Tran T, Aldrighetti L, Jabbour N, Poultsides GA, Gamblin TC, Pawlik TM (2015) Presentation and clinical outcomes of choledochal cysts in children and adults: a multi-institutional analysis. JAMA Surg 150:577–584. https://doi.org/10.1001/jamasurg.2015.0226 CrossRefGoogle Scholar
- 9.Mukai M, Kaji T, Masuya R, Yamada K, Sugita K, Moriguchi T, Onishi S, Yamada W, Kawano T, Machigashira S, Nakame K, Takamatsu H, Ieiri S (2018) The long-term postoperative outcomes of choledochal cysts, focusing on the follow-up rate and late complications at a single institution. Surg Today 48:835–840CrossRefGoogle Scholar
- 10.Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K (1998) Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 51:1037–1044CrossRefGoogle Scholar
- 11.Fukuhara S, Ware JE Jr, Kosinski M, Wada S, Gandek B (1998) Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol 51:1045–1053CrossRefGoogle Scholar
- 12.Kanda Y (2013) Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 48:452–458. https://doi.org/10.1038/bmt.2012.244 CrossRefGoogle Scholar
- 13.Onishi S, Nakame K, Kaji T, Kawano M, Moriguchi T, Sugita K, Yano K, Nomura M, Yamada K, Yamada W, Masuya R, Kawano T, Machigashira S, Mukai M, Ieiri S (2017) The bowel function and quality of life of Hirschsprung disease patients who have reached 18 years of age or older—the long-term outcomes after undergoing the transabdominal soave procedure. J Pediatr Surg 52:2001–2005. https://doi.org/10.1016/j.jpedsurg.2017.08.036 CrossRefGoogle Scholar
- 14.Heistaro S, Jousilahti P, Lahelma E, Vartiainen E, Puska P (2001) Self rated health and mortality: a long term prospective study in eastern Finland. J Epidemiol Community Health 55:227–232CrossRefGoogle Scholar
- 15.Kaplan GA, Camacho T (1983) Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol 117:292–304CrossRefGoogle Scholar
- 16.Okamoto K, Tanaka Y (2004) Subjective usefulness and 6-year mortality risks among elderly persons in Japan. J Gerontol B Psychol Sci Soc Sci 59:246–249CrossRefGoogle Scholar
- 17.Versteegh HP, van Rooij IA, Levitt MA, Sloots CE, Wijnen RM, de Blaauw I (2013) Long-term follow-up of functional outcome in patients with a cloacal malformation: a systematic review. J Pediatr Surg 48:2343–2350. https://doi.org/10.1016/j.jpedsurg.2013.08.027 CrossRefGoogle Scholar
- 18.Guan G, Liu H, Wang Y, Han B, Jin Y (2014) Behavioural and emotional outcomes in school-aged children after surgery or transcatheter closure treatment for ventricular septal defect. Cardiol Young 24:910–917. https://doi.org/10.1017/s104795111300142x CrossRefGoogle Scholar
- 19.Bell LE, Bartosh SM, Davis CL, Dobbels F, Al-Uzri A, Lotstein D, Reiss J, Dharnidharka VR (2008) Adolescent transition to adult care in solid organ transplantation: a consensus conference report. Am J Transplant 8:2230–2242. https://doi.org/10.1111/j.1600-6143.2008.02415.x CrossRefGoogle Scholar
- 20.Clermonts S, van Loon YT, Wasowicz DK, Langenhoff BS, Zimmerman DDE (2018) Comparative quality of life in patients following transanal minimally invasive surgery and healthy control subjects. J Gastrointest Surg. https://doi.org/10.1007/s11605-018-3718-9 Google Scholar