摘要
目的探讨胆囊收缩功能良好的胆囊结石患者行腹腔镜胆囊切除术后胆囊功能缺失对患者的远期影响。方法选择100例胆囊收缩率≥30%的胆囊结石患者,实施腹腔镜胆囊切除术,分别于术前、术后3、12、24个月进行随访,B超测量胆总管内径宽度,观察腹痛、腹泻、脂肪泻发生情况。结果术后3个月胆总管内径的宽度为(7.20±0.6)mm,与术前的(5.3±0.7)mm相比差异有显著性(P<0.01);术后3个月胆总管扩张的发生率为58.1%,与术前比较差异有显著性(P<0.01);术后3个月以后胆总管内径相对稳定。术后3个月患者腹痛的发生率为57.0%,与术前相比差异有显著性(P<0.01),但术后腹痛的性质与术前不同;术后24个月时仍有9.8%的患者存在腹痛。患者于术后3个月时腹泻的发生率为34.4%,脂肪泻发生率为51.6%,与术前相比差异有显著性(P<0.01);术后随着时间的推移腹泻、脂肪泻的发生率逐渐减少,但在术后24个月仍有少数患者存在腹泻(4.3%)、脂肪泻(3.3%)。结论对于术前胆囊收缩功能良好的胆囊结石患者行腹腔镜胆囊切除术后将产生明显的远期并发症,这些并发症在部分患者中长期存在,造成不良影响;其原因为胆囊切除术后胆囊功能缺失。
[ Objective ] To explore the long-term effects on cholecystolithiasis with intact gallbladder functions after laparoseopie cholecysteetomy. [ Methods ] 100 cases of gallbladder systolic rate no lower than 30% and calcu- lous patient tested by B-uhrasound after fat meal were implemented laparoseopic cholecystectomy, all patients re- spectively followed up at the Pre-operation and postoperative 3 months, 12 months, 24 months. Common bile duct diameter was measured by B-ultrasound, abdominal pain, diarrhea and steatorrhea were observed at the same time. [ Results ] Common bile duct diameter was （7.2±0.6） mm at the end of postoperative 3th month, significantly com- pared with （5.3±0.7） mm at Pre-operation statistically （P 〈0.01）. The incidence of common bile duct dilatation was 58.1%, significantly compared with 0 at pre-operation statistically （P 〈0.01）, but common bile duct diameter was no longer expansion at the end of postoperative 3th month. The incidence of abdominal pain was 57.0% at the end of postoperative 3th month, significantly compared with 0 at pre-operation statistically （P 〈0.01）, but But the nature of the abdominal pain was different from postoperation. Postoperative abdominal pain gradually ease after 3 months and still 9.8% in patients with abdominal pain at the end of postoperative 24th month. Diarrhea and steatorrhea occur in most postoperative patients, and the most significant was at the end of postoperative, the incidence of diarrhea and steatorrhea were 34.4% and 51.6% respectively, significantly compared with 0 at preoperation statistically （P 〈0.01）, the incidence of diarrhea and steatorrhea were dwindling with the passage of time, but still a small number of pa- tients with diarrhea （4.3%） and steatorrhea （3.3%） could not be dissipated at the end of postoperative 24th month. [ Conclusions ] Those preoperative Gallbladder contractive function well in patients with gallstones present a signifi- cant long-term complications after laparoscopic cholecystectomy, some of these complications are persistent and cause adverse effects, the reason is arising from gallbladder afunction after cholecystectomy.
出处
《中国内镜杂志》
CSCD
北大核心
2013年第9期906-909,共4页
China Journal of Endoscopy
基金
河北省科技支撑计划项目(No.10276105D-6)
关键词
腹腔镜胆囊切除术
胆囊功能缺失
影响
laparoscopic cholecystectomy
gallbladder afunction
diameter
