Liu Feng, Bai Xue, Duan Guang-Feng, Tian Wen-Hua, Li Zhao-Shen, Song Bin
Feng Liu, Zhao-Shen Li, Bin Song, Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
World J Gastroenterol. 2014 Jul 7;20(25):8237-43. doi: 10.3748/wjg.v20.i25.8237.
To determine quality of life improvement in choledocholithiasis patients who underwent endoscopic sphincterotomy (EST) versus open choledochotomy (OCT).
Eligible choledocholithiasis patients (n = 216) hospitalized in the Changhai Hospital between May 2010 and January 2011 were enrolled into a prospective study using cluster sampling. Patients underwent EST (n = 135) or OCT (n = 81) depending on the patient's wishes. Patients were followed-up with a field survey and by correspondence. Patients were also given the self-administered Gastrointestinal Quality of Life Index (GIQLI) to measure patient quality of life before surgery, and at two and six weeks after the procedures.
With respect to baseline patient characteristics, the EST and OCT groups were comparable. After the procedure, gallstones were completely eliminated in all patients. Among 216 eligible patients, 191 patients (88.4%) completed all three surveys, including 118 patients who underwent EST (118/135; 87.4%) and 73 patients who underwent OCT (73/81; 90.1%). EST was associated with a significantly shorter hospital stay than OCT (8.8 ± 6.5 vs 13.9 ± 6.7 d; P < 0.001). The GIQLI score was similar between the EST and OCT groups before cholelithotomy (103.0 ± 15.4 vs 99.7 ± 10.2), but increased significantly in the EST group at two weeks (113.4 ± 12.0 vs 107.2 ± 11.2; P < 0.001) and six weeks (120.7 ± 10.6 vs 116.9 ± 7.5; P < 0.05) after the procedures.
EST, compared with OCT, is associated with better postoperative quality of life in patients treated for choledocholithiasis.
比较接受内镜括约肌切开术（EST）与开腹胆总管切开术（OCT）的胆总管结石患者生活质量的改善情况。
采用整群抽样法，对2010年5月至2011年1月在长海医院住院的符合条件的胆总管结石患者（n = 216）进行前瞻性研究。根据患者意愿，患者接受EST（n = 135）或OCT（n = 81）治疗。通过现场调查和通信对患者进行随访。术前、术后两周和六周，患者还需自行填写胃肠道生活质量指数（GIQLI），以评估患者的生活质量。
在基线患者特征方面，EST组和OCT组具有可比性。术后，所有患者的胆结石均被完全清除。在216例符合条件的患者中，191例患者（88.4%）完成了全部三项调查，其中118例接受EST治疗（118/135；87.4%），73例接受OCT治疗（73/81；90.1%）。EST组的住院时间明显短于OCT组（8.8±6.5天 vs 13.9±6.7天；P < 0.001）。在胆囊切除术之前，EST组和OCT组的GIQLI评分相似（103.0±15.4 vs 99.7±10.2），但术后两周（113.4±12.0 vs 107.2±11.2；P < 0.001）和六周（120.7±10.6 vs 116.9±7.5；P < 0.05）时，EST组的评分显著升高。
与OCT相比，EST可使胆总管结石患者术后生活质量更佳。
