Eriksen Jens Ravn, Kristiansen Viggo B, Hjortsø Niels-Christian, Rosenberg Jacob, Bisgaard Thue
Amtssygehuset i Glostrup, Kirurgisk Gastroenterologisk Afdeling D.
Ugeskr Laeger. 2005 Jun 13;167(24):2654-6.
The indication for cholecystectomy in symptomatic, uncomplicated gallstone disease varies in the literature, and there is no international consensus. In Denmark, laparoscopic cholecystectomy is recommended for patients with uncomplicated cholecystolithiasis and socially disabling pain. Postoperative health-related quality of life on this indication is unknown.
A prospective consecutive study was conducted. Patients with uncomplicated cholecystolithiasis and socially disabling pain were included and underwent laparoscopic cholecystectomy in the department of day surgery. All patients had uncomplicated gallstone disease. An internationally validated questionnaire, the Gastrointestinal Quality of Life Index (GIQLI), was completed one week before and six weeks after the operation. The questionnaire comprises 32 questions covering five items related to gastrointestinal disease, and each question is rated on a scale of 0 to 4 points. The maximum GIQLI score (GIQLI total) is 128 points (32 x 4 points) and represents the best possible health-related quality of life.
75 consecutive patients (62 women) underwent uneventful operations. All patients returned the pre- and postoperative questionnaire. The median age was 42 years (range 18-69), the median body mass index was 26 (19-39) and the median operation time was 56 minutes (24-130). The median GIQLI total scores were 99 (33-127) and 112 (82-128) before and after operation, respectively (P < 0.001). Scores on all five sub-items were significantly improved as well.
Laparoscopic cholecystectomy improves the health-related quality of life six weeks after the operation in patients with socially disabling, uncomplicated cholecystolithiasis.
在有症状的单纯性胆结石疾病中，胆囊切除术的适应症在文献中存在差异，且尚无国际共识。在丹麦，对于患有单纯性胆囊结石且疼痛导致社交功能受限的患者，推荐进行腹腔镜胆囊切除术。基于该适应症的术后健康相关生活质量尚不清楚。
进行了一项前瞻性连续研究。纳入患有单纯性胆囊结石且疼痛导致社交功能受限的患者，并在日间手术科室接受腹腔镜胆囊切除术。所有患者均患有单纯性胆结石疾病。在手术前一周和手术后六周完成一份经过国际验证的问卷，即胃肠道生活质量指数（GIQLI）。该问卷包含32个问题，涵盖与胃肠道疾病相关的五个项目，每个问题的评分范围为0至4分。GIQLI的最高得分（GIQLI总分）为128分（32×4分），代表最佳的健康相关生活质量。
75例连续患者（62例女性）手术顺利。所有患者均返回了术前和术后问卷。中位年龄为42岁（范围18 - 至69岁），中位体重指数为26（19 - 39），中位手术时间为56分钟（24 - 130分钟）。术前和术后GIQLI总分的中位数分别为99分（33 - 127分）和112分（82 - 128分）（P < 0.001）。所有五个子项目的得分也均有显著改善。
对于因单纯性胆囊结石导致社交功能受限的患者，腹腔镜胆囊切除术可在术后六周改善其健康相关生活质量。
