Hogan Aisling M, Hoti Emir, Winter Desmond C, Ridgway Paul F, Maguire Donal, Geoghegan Justin G, Traynor Oscar
St. Vincent's University Hospital, Dublin, Ireland.
Ann Surg. 2009 Feb;249(2):292-5. doi: 10.1097/SLA.0b013e318195c50c.
To compare quality of life (QOL) of patients following iatrogenic bile duct injuries (BDI) to matched controls.
BDI complicate approximately 0.3% of all cholecystectomy procedures. The literature regarding impact on quality of life is conflicted as assessment using clinical determinants alone is insufficient.
The medical outcomes study short form 36 (SF-36), a sensitive tool for quantification of life quality outcome, was used. The study group of iatrogenic BDI was compared with an age- and sex-matched group who underwent uncomplicated cholecystectomy. Telephone questionnaire using the SF-36 quality of life tool was administered to both groups at a median postoperative time of 12 years 8 months (range, 2 months -20 years).
Seventy-eight patients were referred with BDI but due to mortality (n = 10) and unavailability (n = 6) 62 participated. The age- and sex-matched control cohort had undergone uncomplicated cholecystectomy (n = 62). Comparison between groups revealed that 7 of 8 variables examined were statistically similar to those of the control group (physical functioning, role physical, bodily pain, general health perceptions, vitality and social functioning, and mental health index). Mean role emotional scores were slightly worse in the BDI group (46 vs. 50) but the significance was borderline (P = 0.045). Subgroup analysis by method of intervention for BDI did not demonstrate significant differences.
Quality of life of surviving patients following BDI compares favorably to that after uncomplicated laparoscopic cholecystectomy.
比较医源性胆管损伤（BDI）患者与匹配对照组的生活质量（QOL）。
BDI在所有胆囊切除术患者中约占0.3%。关于其对生活质量影响的文献存在矛盾，因为仅使用临床指标进行评估是不够的。
采用医学结局研究简表36（SF - 36），这是一种用于量化生活质量结局的敏感工具。将医源性BDI研究组与年龄和性别匹配的单纯胆囊切除术组进行比较。在术后中位时间12年8个月（范围2个月至20年），对两组进行电话问卷调查，使用SF - 36生活质量工具。
78例患者因BDI前来就诊，但由于死亡（n = 10）和无法联系（n = 6），62例患者参与研究。年龄和性别匹配的对照组进行了单纯胆囊切除术（n = 62）。组间比较显示，所检查的8个变量中有7个在统计学上与对照组相似（身体功能、角色功能、身体疼痛、总体健康感知、活力、社会功能和心理健康指数）。BDI组的平均角色情感得分略低（46对50），但差异接近临界值（P = 0.045）。按BDI干预方法进行的亚组分析未显示出显著差异。
BDI存活患者的生活质量与单纯腹腔镜胆囊切除术后患者的生活质量相比具有优势。
