腹腔镜胆囊切除术在病态肥胖和超级肥胖患者中的安全性和有效性。
Safety and efficacy of a laparoscopic cholecystectomy in the morbid and super obese patients.
作者信息
Tiong Leong, Oh Jaewook
机构信息
Department of Surgery, Lyell McEwin Hospital, Adelaide, SA, Australia.
出版信息
HPB (Oxford). 2015 Jul;17(7):600-4. doi: 10.1111/hpb.12415. Epub 2015 Apr 23.
BACKGROUND
Although a laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic cholelithiasis, its safety and efficacy in the morbidly/super obese patients is unknown. The aim of this study was to investigate the safety and efficacy of an elective LC in the morbid/super obese patients.
METHODS
A retrospective review of the hospital electronic database and medical records was conducted searching for all elective LC from 2010 to 2013. The data collected included patient demographics and body mass index (BMI), length of hospital stay (LOS), duration of surgery (DOS), intra- and post-operative complications, bile duct injuries, performance of an intra-operative cholangiogram, the incidence of open conversion and the seniority of the operator.
RESULTS
A total of 799 patients (76% female) with a mean age of 46 years and BMI of 31 were included in this study. There were significant differences in the median DOS between the three BMI groups; BMI < 26 [64 min; interquartile range (IQR) 54-83]; BMI 26-40 (72 min, IQR 58-91) and BMI > 40 (82 min, IQR 63-104), P < 0.001. There were no statistically significant differences in the LOS, peri-operative complication rates, open conversions or bile duct injuries among the BMI groups.
CONCLUSIONS
This study showed that LC can be performed safely in the morbid/super obese patients.
背景
尽管腹腔镜胆囊切除术（LC）是有症状胆结石的金标准治疗方法，但其在病态/超级肥胖患者中的安全性和有效性尚不清楚。本研究的目的是调查择期LC在病态/超级肥胖患者中的安全性和有效性。
方法
对医院电子数据库和病历进行回顾性研究，搜索2010年至2013年所有择期LC病例。收集的数据包括患者人口统计学和体重指数（BMI）、住院时间（LOS）、手术时间（DOS）、术中和术后并发症、胆管损伤、术中胆管造影的实施情况、中转开腹率以及术者年资。
结果
本研究共纳入799例患者（76%为女性），平均年龄46岁，BMI为31。三个BMI组之间的中位DOS存在显著差异；BMI<26[64分钟；四分位间距（IQR）54 - 83]；BMI 26 - 40（72分钟，IQR 58 - 91）和BMI>40（82分钟，IQR 63 - 104），P<0.001。BMI组之间在LOS、围手术期并发症发生率、中转开腹率或胆管损伤方面无统计学显著差异。
结论
本研究表明，LC可在病态/超级肥胖患者中安全实施。
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