McNamara D A, O'Donohoe M K, Horgan P G, Tanner W A, Keane F B
Department of Surgery, Meath/Adelaide Hospitals, Dublin 8.
Ir J Med Sci. 1998 Jan-Mar;167(1):11-3. doi: 10.1007/BF02937544.
Previous studies have shown that up to 40 per cent of patients have symptoms after cholecystectomy or laparoscopic cholecystectomy (LC). There are concerns, however, that these symptoms reflect those of the general population and are not a specific post-operative phenomenon. Abdominal symptoms of 212 patients following LC were compared to a healthy acalculous control population (n = 62). Patients and controls were assessed by questionnaire. Age and sex profiles were similar in both groups. There was no significant difference in the incidence of abdominal pain, bloating or nausea between the 2 groups. Frequent heartburn was a symptom in 19.3 per cent of patients following LC as compared to 3.2 per cent of control patients (p = 0.004, chi-squared 9.39, 1 d.f.). Furthermore 11.3 per cent of post-operative patients complained of dysphagia versus 6.4 per cent of the control group (p = 0.08, chi-squared 1.245, 1 d.f.). One hundred and twenty (57.1 per cent) patients judged their operation to be a complete success, while 9 (4.3 per cent) were dissatisfied. Five of the latter group cited frequent heartburn as the cause of their dissatisfaction. We conclude that abdominal pain, bloating and nausea occur as frequently in the general population as in patients following LC. Patients are more likely to suffer from heartburn and dysphagia following LC than a normal population supporting a link between cholecystectomy and lower oesophageal dysfunction.
以往研究表明,高达40%的患者在胆囊切除术或腹腔镜胆囊切除术(LC)后会出现症状。然而,有人担心这些症状反映的是普通人群的症状,而非特定的术后现象。将212例接受LC术后患者的腹部症状与健康的无结石对照人群(n = 62)进行比较。通过问卷调查对患者和对照者进行评估。两组的年龄和性别分布相似。两组之间在腹痛、腹胀或恶心的发生率上没有显著差异。LC术后患者中19.3%有频繁烧心症状,而对照患者中这一比例为3.2%(p = 0.004,卡方值9.39,自由度1)。此外,11.3%的术后患者主诉吞咽困难,而对照组为6.4%(p = 0.08,卡方值1.245,自由度1)。120例(57.1%)患者认为其手术非常成功,而9例(4.3%)不满意。后一组中有5例将频繁烧心作为其不满意的原因。我们得出结论,普通人群中腹痛、腹胀和恶心的发生率与LC术后患者相似。LC术后患者比正常人群更容易出现烧心和吞咽困难,这支持了胆囊切除术与食管下段功能障碍之间的联系。