手术治疗慢性非结石性胆囊炎的疗效的回顾性队列研究

A cohort study of outcome after cholecystectomy for chronic acalculous cholecystitis

目的探讨慢性非结石性胆囊炎外科治疗的疗效。方法对2004年1月～2010年5月间的手术治疗慢性非结石性胆囊炎和慢性结石性胆囊炎的病例的临床资料进行回顾性分析。结果两组在术后疼痛评分平均随访时间为2.1±0.3年,慢性非结石性胆囊炎组由术前疼痛评分9.2逐步降至0.3(P<0.001)。慢性结石性胆囊炎组由术前疼痛评分8.4逐步降至0.1(P<0.001)。两组在疼痛变化方面比较差异不明显(P>0.05)。其中1例慢性非结石性胆囊炎及3例慢性结石性胆囊炎患者右上腹胆绞痛无明显缓解。结论手术治疗慢性手术治疗慢性非结石性胆囊炎和慢性结石性胆囊炎的在缓解患者术后疼痛方面具有相类似的疗效,手术对于缓解慢性非结石性胆囊炎的胆绞痛是有效的。

Objective To investigate the outcome of patients ~treated with cholecystectomy for chronic acalculous cholecystitis （CAC）. Methods A controlled, retrospective cohort study assessing biliary pain （ preoperative and at follow-up） in postcholecystec- tomy patients with CAC or CCC was performed. Results In 56 CAC and with matched CCC control patients, the mean duration of symptoms before surgery was 13.7 ± 0. 52month and 6. 3 ± 0. 71months, respectively. The mean follow-up for both groups was 3.12 ± 1.1 and 3.36 ± 0. 96 years. Both groups benefited from cholecystectomy （ P 〈 0. 001 ） , and both were equally likely to be pain-free up- on long-term follow-up （55 CAC versus 52 CCC, P 〉 0. 05 ）. Conclusions There was no difference in outcome between the groups after an average follow-up . Postcholecystectomy patients with chronic cholecystitis and no gallstones have complete pain resolution, similar to patients with gallstones.