微创保胆取石术与胆囊取出术对胆囊结石患者中长期生活水平的影响

目的 探究微创保胆取石术与取出术对胆囊结石患者中长期生活水平的影响.方法 将2008年1月至2013年1月至三峡大学第二人民医院肝胆外科住院、接受胆囊微创手术 (微创保胆取石术或微创胆囊取出术) 并符合纳入标准的214例胆囊结石患者纳入研究, 分为微创保胆组和微创取胆组, 各107例;手术由同一位主任医师操作.术后半年、3 a、5 a对比2组患者胆囊、肝脏、胰腺并发症情况及LDQ功能性消化不良评分.结果术后半年2组胆囊、肝脏、胰腺并发症发生情差异无统计学意义 (P>0.05) , LDQ功能性消化不良评分微创保胆组高于微创取胆组 (P<0.05) .术后3 a、5 a 2组胆囊、肝脏、胰腺并发症发生情况有差异 (P<0.05) , LDQ功能性消化不良评分微创保胆组与微创取胆组无差异 (P>0.05) .结论 从长远来看, 病情较复杂胆囊结石患者对具体术式难以取舍时适宜采用微创取胆术治疗.

Observations on the Mid-and-Long Term Impact of Minimally Invasive Lithotomy and Cholecystectomy on the Living Status of Patients with Cholelithiasis

Objective To investigate the mid-and-long term impact of minimally invasive lithotomy and cholecystectomy on the living status of patients with cholelithiasis. Me thods From January 2008 to January 2013, 214 cases who had received minimally invasive surgery in cholecyst (either minimally invasive lithotomy or minimally invasive cholecystectomy) and complied with study eligibility were recruited in the study. They were divided into minimally invasive lithotomy group and minimally invasive cholecystectomy group with 107 cases in each group. All the surgeries were performed by an experienced senior chief physician. Follow-up in half a year, 3 years and 5 years after surgery was conducted to evaluate the complications of cholecyst, liver and pancreas in patients, as well as their LDQ digestive function between the two groups. Re s ults There was no significant different in the complications of cholecyst, liver and pancreas in patients of two groups in 6 months after surgery (P >0.05) .while, the LDQ digestive function was worse in patients receiving minimally invasive lithotomy group than in minimally invasive cholecystectomy group 6 months after surgery (P <0.05) . In 3 years and 5 years after the surgery, evaluation on complications of cholecyst, liver and pancreas in both groups showed significant difference (P<0.05) , however, the evaluation of LDQ digestive function showed no difference between the two groups (P >0.05) . Conclusion From a long-term perspective, for patients with complex cholecystolithiasis, physicians may choose the minimally invasive cholecystectomy for better effects.