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胆囊切除术后五年,许多患者仍持续存在疼痛:来自两项针对有症状、非复杂性胆结石疾病和急性胆囊炎的随机对照试验的观察结果。

Pain persists in many patients five years after removal of the gallbladder: observations from two randomized controlled trials of symptomatic, noncomplicated gallstone disease and acute cholecystitis.

作者信息

Vetrhus Morten, Berhane Tewelde, Søreide Odd, Søndenaa Karl

机构信息

Department of Surgery, Stavanger University Hospital, Stavanger, Norway.

出版信息

J Gastrointest Surg. 2005 Jul-Aug;9(6):826-31. doi: 10.1016/j.gassur.2005.01.291.

Abstract

After removal of the gallbladder, pain may persist in some patients. To study this condition, 124 patients from two randomized trials, including those with symptomatic noncomplicated gallbladder stones (n = 90) and acute cholecystitis (n = 34), were interviewed, while 139 patients (90%) excluded from both trials responded to a questionnaire 5 years after the operation. Thirty-four patients (27%) of those randomized had pain; 23 (18%) had diffuse, steady pain; and 11 (9%) had pain attacks resembling their preoperative symptoms. A significant dominance of diffuse pain occurred in women (P = 0.024), especially those younger than 60 years (P = 0.004). A tendency for the diffuse type to be dominant was also present in the group of female patients with symptomatic noncomplicated gallbladder stones (P = 0.052). Of the excluded patients, 18% (25/139) had pain, but 88% of them (96% of the men and 87% of the women) were satisfied with the result of the operation. The overall number of patients with postoperative pain was 22% (59/263). We conclude that persisting abdominal pain 5 years after the operation was mainly of a nonspecific type, found mostly in younger women who had had noncomplicated gallstone disease. Eighty-eight percent of the excluded patients declared themselves satisfied with the result of cholecystectomy.

摘要

胆囊切除术后,部分患者可能仍会感到疼痛。为研究这种情况,对两项随机试验中的124例患者进行了访谈,其中包括有症状的非复杂性胆囊结石患者(n = 90)和急性胆囊炎患者(n = 34),同时139例被两项试验排除的患者在术后5年对一份问卷做出了回应。随机分组的患者中有34例(27%)感到疼痛;23例(18%)有弥漫性、持续性疼痛;11例(9%)有类似术前症状的疼痛发作。弥漫性疼痛在女性中显著占主导(P = 0.024),尤其是60岁以下的女性(P = 0.004)。有症状的非复杂性胆囊结石女性患者组中也存在弥漫性疼痛占主导的趋势(P = 0.052)。在被排除的患者中,18%(25/139)有疼痛,但其中88%(男性为96%,女性为87%)对手术结果满意。术后疼痛患者的总数为22%(59/263)。我们得出结论,术后5年持续存在的腹痛主要是非特异性类型,多见于患有非复杂性胆结石疾病的年轻女性。88%的被排除患者表示对胆囊切除术的结果满意。

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