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腹腔镜胆囊切除术后的症状性结局

Symptomatic outcome after laparoscopic cholecystectomy.

作者信息

Wilson R G, Macintyre I M

机构信息

Department of Surgery, Western General Hospital, Edinburgh, UK.

出版信息

Br J Surg. 1993 Apr;80(4):439-41. doi: 10.1002/bjs.1800800410.

Abstract

To evaluate the symptomatic outcome after laparoscopic cholecystectomy, a standard symptom questionnaire was sent to three patient groups at least 1 year after surgery: 115 patients had undergone laparoscopic cholecystectomy; 200 had undergone open cholecystectomy; and 200 had had inguinal hernia repair. Return of questionnaires was higher after laparoscopic cholecystectomy (100 of 115; 87.0 per cent) than the open procedure (167 of 200; 83.5 per cent) or hernia repair (163 of 200; 81.5 per cent). There was no difference in the number of patients who considered the operation to have cured or improved their preoperative symptoms after laparoscopic cholecystectomy (94 of 100; 94.0 per cent), open cholecystectomy (157 of 167; 94.0 per cent) or hernia repair (154 of 163; 94.5 per cent). Similar numbers considered their operation to have been a success (94.0, 95.2 and 94.5 per cent respectively). The prevalence of abdominal pain, nausea, flatulence, food intolerance and heartburn was similar in all groups of patients following operation. Diarrhoea occurred more often following laparoscopic (6.0 per cent) and open (4.2 per cent) cholecystectomy than hernia repair (1.2 per cent). Patients who underwent laparoscopic cholecystectomy tended to have a higher incidence of nausea or vomiting than those undergoing the open procedure, and consumed significantly more antacids (23.0 versus 12.0 per cent, P < 0.02). Laparoscopic cholecystectomy achieved the same rate of patient satisfaction as open cholecystectomy, with no apparent symptomatic advantage.

摘要

为评估腹腔镜胆囊切除术后的症状转归,在术后至少1年向三组患者发放了标准症状调查问卷:115例行腹腔镜胆囊切除术;200例行开腹胆囊切除术;200例行腹股沟疝修补术。腹腔镜胆囊切除术后问卷回收率(115例中的100例,87.0%)高于开腹手术(200例中的167例,83.5%)或疝修补术(200例中的163例,81.5%)。腹腔镜胆囊切除术后认为手术治愈或改善了术前症状的患者数量(100例中的94例,94.0%)、开腹胆囊切除术(167例中的157例,94.0%)或疝修补术(163例中的154例,94.5%)无差异。认为手术成功的患者数量相似(分别为94.0%、95.2%和94.5%)。术后所有患者组中腹痛、恶心、腹胀、食物不耐受和烧心的发生率相似。腹腔镜(6.0%)和开腹(4.2%)胆囊切除术后腹泻发生率高于疝修补术(1.2%)。行腹腔镜胆囊切除术的患者恶心或呕吐发生率往往高于开腹手术患者,且抗酸剂消耗量显著更多(23.0%对12.0%,P<0.02)。腹腔镜胆囊切除术与开腹胆囊切除术的患者满意度相同,无明显症状优势。

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