腹腔镜下肝叶切除术联合胆道镜对复杂肝内外胆管结石患者肝功能及生活质量的影响

Effects of laparoscopic and choledochoscopic hepatectomy on liver function and quality of life in patients with complicated intra-and extra-hepatic bile duct stones

目的:探讨腹腔镜下肝叶切除术联合胆道镜对复杂肝内外胆管结石患者肝功能及生活质量的影响。方法:选择某院收治的复杂性肝内外胆管结石患者96例,随机分为对照组和观察组,每组各48例。对照组给予开腹肝叶切除术治疗,观察组给予腹腔镜联合胆道镜肝叶切除治疗,比较分析2组患者术后肝功能、生活质量及并发症发生率。结果:术后2组患者肝功能各项指标水平较术前明显降低,其中观察组白蛋白含量高于对照组,丙氨酸氨基转移酶水平低于对照组(P<0.05);术后1、4、8周观察组胃肠生活质量指数(GIQLI)评分均高于对照组(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜下肝叶切除术联合胆道镜治疗复杂肝内外胆管结石疗效满意,对患者肝功能影响较小,有利于提高患者生活质量,降低并发症发生率。

Objective:To explore effects of laparoscopic and choledochoscopic hepatectomy on liver function and quality of life in patients with complicated intra-and extra-hepatic bile duct stones(IE-BDS).Methods:A total of 96 patients with complicated IE-BDS were randomly divided into a control group and an observation group,with 48 cases in each.The control group underwent open hepatectomy,while the observation group was treated with laparoscopic and choledochoscopic hepatectomy.The differences in terms of postoperative liver function,quality of life and complications were compared between the two groups.Results:After the surgery,the levels of all liver function indexes in both groups were significantly decreased.Compared with control group,albumin(ALB)level was higher and alanine aminotransferase(ALT)level was lower in the observation group(P<0.05).1 week,4 weeks and 8 weeks after the surgery,scores of gastrointestinal quality of life index(GIQLI)in the observation group were higher than those in the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion:Laparoscopic and choledochoscopic hepatectomy in treatment of patients with complicated IE-BDS enjoys satisfactory curative result,with little effect on their liver function.It is safe,effective and conducive to improving quality of life.