Patients and methods: In March 2005 a survey was performed of 403 eligible patients with BDI who were referred to a tertiary center for multidisciplinary treatment by gastroenterologists, radiologists, and surgeons. A longitudinal quality-of-life study was performed to determine changes in outcome after a mean of 5.5 and 11 years’ follow-up.

Results: Of the eligible 403 patients with BDI, 278 (69?%) responded to the survey after a mean follow-up of 5.9 years. The quality-of-life outcome of injured patients was significantly lower in three of the eight domains compared to patients who underwent cholecystectomy without an injury (P?<?0.05). In seven of the eight QoL domains injured patients scored significantly worse than the healthy population norms (P?<?0.05). The longitudinal assessment after another 5.5 years of follow-up did not show improvement in QoL. Clinical characteristics such as the type of injury and the type of treatment did not affect outcome. Nineteen percent of the patients (n?=?53) filed a malpractice claim after BDI. These patients reported better QoL (effect size?=?0.6, P?=?0.02) when the claim was resolved in their favor than when the claim was rejected.

Conclusions: BDI has a detrimental effect on long-term QoL. QoL in patients with BDI is poor and does not improve during follow-up. The outcome of a malpractice litigation claim is associated with QoL.