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目的比较腹腔镜下保胆取石术与腹腔镜下胆囊切除术治疗儿童胆囊结石对其生长发育及生活质量的影响。方法选择2011年7月至2014年6月入住我科行腹腔镜保胆取石的患儿25例为腹腔镜保胆取石组(保胆组),另选择同期行腹腔镜胆囊切除的患儿27例为腹腔镜胆囊切除组(切除组)。分别测定2组患儿术前及术后6个月,1、2、3年的身高、体质量及消化病生存质量指数(gastrointestinal quality of life index,GLQI)。结果保胆组及切除组术前身高及体质量分别为119 cm、22 kg及121 cm、23 kg。术后6个月,无论是保胆组还是切除组,身高及体质量均较术前增加,差异有统计学意义(P<0.05)。术后1年,保胆组患儿的身高及体质量均超过切除组,但差异无统计学意义(P>0.05)。术后2、3年,保胆组患儿身高及体质量的增长程度均超过切除组,差异有统计学意义(P<0.05),而且切除组患儿的身高及体质量均处于正常学龄期儿童平均身高及体质量的低限(正常学龄期儿童身高:136.8~144.7 cm,体质量:29.8~34.1 kg)。保胆组及切除组术前GLQI指数分别为112分及109分。术后6个月,保胆组及切除组GLQI指数均超过术前(P<0.05)。术后1年,保胆组的GLQI指数达到正常水平(123分),且较切除组(114分)有明显升高(P<0.05),主要表现在主观症状及心理情绪状态方面。术后2、3年,切除组GLQI指数(116、119分)较保胆组(124、125分)有了更明显的降低(P<0.01)。术后第3年,切除组患儿的GLQI指数也未达到正常水平。结论腹腔镜下保胆取石术较腹腔镜下胆囊切除术更有利于患儿的生长发育及提高生存质量。
Objective To compare the effect of laparoscopic gallbladder surgery and laparoscopic cholecystectomy on children gallbladder stone growth and quality of life. Methods From July 2011 to June 2014, 25 children who underwent laparoscopic gallbladder removal in our department were laparoscopic gallbladder removal group (GGT group). Another 27 children undergoing laparoscopic cholecystectomy during the same period Case of laparoscopic cholecystectomy group (resection group). The height, body mass, and gastrointestinal quality of life index (GLQI) were measured before operation, 6 months, 1, 2 and 3 years after operation in both groups. Results Pre-gall bladder height and body mass of the bolus group and the resection group were 119 cm, 22 kg and 121 cm, respectively, and 23 kg. At 6 months after operation, the height and body mass of both the bolus group and the resection group increased significantly compared with that before operation (P <0.05). One year after operation, the height and body weight of children in BaoGan group were higher than those in resection group, but the difference was not statistically significant (P> 0.05). At 2 and 3 years after operation, the height and body weight of the children with gallbladder increased more than that of the resection group (P <0.05), and the height and weight of children in the resection group were in normal school age Children’s average height and body mass of the lower limit (normal school-age children height: 136.8 ~ 144.7 cm, body mass: 29.8 ~ 34.1 kg). Pre-gall bladder group and resection group preoperative GLQI index was 112 points and 109 points. At 6 months after operation, the GLQI index in the bolus group and resection group were all higher than those before operation (P <0.05). At 1 year after operation, the GLQI index of Baogan group reached a normal level (123 points) and significantly higher than that of the resection group (114 points) (P <0.05), mainly in subjective symptoms and psychological and emotional state. After 2 and 3 years, the GLQI index (116 and 119) in the resection group was significantly lower than that in the GBA group (124 and 125) (P <0.01). In the third year after surgery, the GLQI index of children in the resection group did not reach the normal level. Conclusion Laparoscopic gallbladder surgery than laparoscopic cholecystectomy is more conducive to the growth and development of children and improve the quality of life.