胆道镜联合腹腔镜对保胆取石患者胃肠功能及生存质量研究

目的:评价经纤维胆道镜+腹腔镜微创保胆取石手术的临床效果.方法:将121例择期手术的胆囊功能正常的胆囊结石患者随机分为观察组(采用纤维胆道镜+腹腔镜微创保胆取石术)和对照组(采用腹腔镜胆囊切除术),比较两组术后胃肠功能及术前、术后2,4,8周及6个月的消化系统疾病生存质量指数(GIQLI)的变化.结果:观察组术后肠鸣音恢复时间、肛门排气及排便时间均明显短于对照组,胃肠道不良反应发生率及复发率均低于对照组(均P＜0.05)；两组术前GIQLI无统计学差异(P＞0.05),但术后2,4,8周观察组GIQLI均明显高于对照组(均P＜0.01),至术后6个月两组的GIQLI基本接近(P＞0.05).结论:胆道镜+腹腔镜保胆取石术后患者胃肠功能恢复更快,短期内生存质量提升更高.

Gastrointestinal function and quality of life in patients after combined choledochoscopic and laparoscopic gallbladder-preserving cholecystolithotomy

Objective: To the clinical efficacy of minimally invasive combined choledochofiberscopic and laparoscopic cholecystolithotomy with gallbladder preservation. Methods: One hundred and twenty-two patients with gallstone and normal gallbladder function scheduled for surgical treatment were randomly divided into observational group (undergoing minimally invasive combined choledochofiberscopic and laparoscopic cholecystolithotomy with gallbladder preservation) and control group (undergoing laparoscopic cholecystectomy). The gastrointestinal function and gastrointestinal quality of life index (GIQLI) between the two groups of patients before operation, and 2, 4 and 8 weeks as well as 6 months after operation were compared. Results: The time to bowel sounds restoration, and anal flatus and defecation were significantly shortened, and the incidence of gastrointestinal adverse reactions and recurrence in observational group were significantly reduced compared with control group (all P<0.05). The GIQLI scores had no significant difference between the two groups before operation (P>0.05), but they were significantly higher in observational group than those in control group at 2, 4 and 8 weeks after operation (all P<0.05), and then the two groups became similar at 6 months after operation (P>0.05). Conclusion: For gallstone patients, combined choledochofiberscopic and laparoscopic cholecystolithotomy with gallbladder preservation has the advantages of faster recovery of gastrointestinal function, and better quality of life in the early postoperative period.