Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Graduate School, Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea.
Medicine (Baltimore). 2022 Feb 4;101(5):e28794. doi: 10.1097/MD.0000000000028794.
One of the most important reasons for avoiding percutaneous transhepatic gall bladder drainage (PTGBD) is the deterioration of quality of life (QOL). However, there is no study comparing the QOL between primary laparoscopic cholecystectomy (LC) and LC following PTGBD.Among the LC patients, 69 non-PTGBD patients and 21 PTGBD patients were included after excluding the patients with malignant disease or who needed additional common bile duct procedures. Clinicopathologic characteristics and surgical outcomes were compared. QOL was evaluated with questionnaire EORCT-C30 before and after surgery.The included patients comprised 69 non-PTGBD and 21 PTGBD patients. The PTGBD group include older and higher morbid patients. PTGBD group needed longer operation times than the non-PTGBD group (72.4±34.7 minute vs 52.8±22.0 minute, P = .022) Regarding the overall incidence of complication, the PTGBD group had a significantly higher complication rate than the non-PTGBD group (38.1% vs 10.1%, P = .003) However, there was no significant difference in severe complication). Regarding the QOL, both the functional and global health scales were improved following surgery compared to the preoperative evaluation. Comparative analysis of the 2 groups showed no significant difference in global heath scale either preoperative or postoperatively, while the functional scale and emotional scale were better in the PTGBD group compared to the non-PTGBD group. Regarding the symptom scale, postoperative dyspnea and perioperative diarrhea were better in the PTGBD group.LC following an interval from earlier PTGBD that targets acute cholecystitis or complicated GB had little to no impact on QOL when compared to standard LC.
避免经皮经肝胆囊引流术(PTGBD)的最重要原因之一是生活质量(QOL)恶化。然而,目前尚无比较经皮经肝胆囊引流术和经皮经肝胆囊引流术后腹腔镜胆囊切除术(LC)患者 QOL 的研究。
排除恶性疾病或需要额外行胆总管手术的患者后,我们纳入了 69 例非经皮经肝胆囊引流术和 21 例经皮经肝胆囊引流术后 LC 患者。比较两组患者的临床病理特征和手术结果。术前和术后采用 EORCT-C30 问卷评估 QOL。
纳入的患者包括 69 例非经皮经肝胆囊引流术和 21 例经皮经肝胆囊引流术后 LC 患者。经皮经肝胆囊引流术组患者年龄较大,合并症较多。经皮经肝胆囊引流术组的手术时间长于非经皮经肝胆囊引流术组(72.4±34.7 分钟比 52.8±22.0 分钟,P=0.022)。PTGBD 组的总体并发症发生率显著高于非 PTGBD 组(38.1%比 10.1%,P=0.003),但严重并发症发生率无显著差异。QOL 方面,与术前评估相比,术后所有功能和总体健康量表评分均得到改善。对两组患者进行比较分析,术前和术后总体健康量表评分均无显著差异,而 PTGBD 组患者的功能量表和情绪量表评分优于非 PTGBD 组。PTGBD 组患者术后呼吸困难和围手术期腹泻症状较非 PTGBD 组患者明显改善。
与标准 LC 相比,针对急性胆囊炎或复杂胆囊的早期经皮经肝胆囊引流术间隔期行 LC 对 QOL 几乎没有影响。