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开腹胆囊切除术后的长期随访

Long-term follow-up after open cholecystectomy.

作者信息

Konsten J, Gouma D J, von Meyenfeldt M F, Menheere P

机构信息

Department of Surgery, Maastricht University Hospital, The Netherlands.

出版信息

Br J Surg. 1993 Jan;80(1):100-2. doi: 10.1002/bjs.1800800132.

Abstract

The long-term outcome of open cholecystectomy was investigated. Follow-up data at a median of 10 years were obtained from physicians' records on 325 (92.6 per cent) of 351 patients treated for symptomatic gallbladder stones by open cholecystectomy between 1978 and 1980. One 79-year-old patient died after operation, from a pulmonary complication. Of the 325 patients, 81.5 per cent were currently asymptomatic or had not had symptoms during follow-up until death. Sixty patients (18.5 per cent) had complaints after 10 years. Stone recurrence was found in five patients (1.5 per cent); ten others (3.1 per cent) had biliary tract-related complaints during follow-up. Blood samples were obtained in 67.3 per cent of surviving patients with biliary complaints. There were no laboratory findings associated with biliary obstruction. Patients with typical symptoms of gallstone disease before surgery had significantly fewer complaints during follow-up than those with typical as well as atypical symptoms (14.8 versus 26.5 per cent, P < 0.02). However, most of these complaints were not related to the procedure. It is concluded that the majority of patients reported no complaints or postcholecystectomy symptoms 10 years after surgery.

摘要

对开腹胆囊切除术的长期结果进行了调查。从1978年至1980年期间接受开腹胆囊切除术治疗有症状胆囊结石的351例患者中的325例(92.6%)的医生记录中获得了中位随访10年的数据。1例79岁患者术后死于肺部并发症。在325例患者中,81.5%目前无症状或在随访直至死亡期间未出现症状。60例患者(18.5%)在10年后出现不适。5例患者(1.5%)发现结石复发;另外10例患者(3.1%)在随访期间有胆道相关不适。67.3%有胆道不适的存活患者采集了血样。未发现与胆道梗阻相关的实验室检查结果。术前有典型胆结石症状的患者在随访期间的不适明显少于有典型和非典型症状的患者(14.8%对26.5%,P<0.02)。然而,这些不适大多与手术无关。得出的结论是,大多数患者在术后10年未报告不适或胆囊切除术后症状。

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