在减肥手术中合并胆囊切除术与延迟胆囊切除术的比较。

IF 3.8 Q2 ENDOCRINOLOGY & METABOLISM Journal of Obesity Pub Date : 2021-06-14 eCollection Date: 2021-01-01 DOI:10.1155/2021/9957834
Hatem Elgohary, Mahmoud El Azawy, Mohey Elbanna, Hossam Elhossainy, Wael Omar
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引用次数: 3

摘要

背景:减肥手术后的肥胖和体重减轻与胆囊疾病密切相关。腹腔镜胆囊切除术(LC)与减肥手术的性能和适当的时机仍然是一个临床问题。目的:根据术中困难程度的不同,评价在减肥手术中同时进行或延迟进行LC的效果。方法:前瞻性研究纳入2018年12月至2019年12月期间术前检查出胆囊结石的病态肥胖患者。根据难易程度将患者分为两组:第一组为在减肥手术中同时行LC的患者,第二组为2个月后延迟行LC的患者。结果:1组和2组的手术时间分别为92.63±28.25和68.33±17.49 (p < 0.001), A组和B组的手术时间分别为84.19±19.62和130.0±31.62 (p < 0.001)。两组各有1例梗阻性黄疸(2.6%和8.3%),p > 0.001。在第二组中,33%的无症状患者出现胆绞痛症状(p > 0.001)。LC难度评分1组为2.11±0.70,2组为5.66±0.98,p < 0.001。减肥手术2个月后,LC难度评分由5.66±0.98降至2.26±0.78,p < 0.001。结论:减肥手术期间LC的时机是具有挑战性的,应该针对每个患者进行优化,因为计划在2个月后进行困难的LC可能是一种选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Concomitant versus Delayed Cholecystectomy in Bariatric Surgery.

Background: Obesity and weight loss after bariatric surgery have a close association with gallbladder disease. The performance and proper timing of laparoscopic cholecystectomy (LC) with bariatric surgery remain a clinical question.

Objective: Evaluation of the outcome of LC during bariatric surgery whether done concomitantly or delayed according to the level of intraoperative difficulty.

Methods: The prospective study included patients with morbid obesity between December 2018 and December 2019 with preoperatively detected gallbladder stones. According to the level of difficulty, patients were allocated into 2 groups: group 1 included patients who underwent concomitant LC during bariatric surgery, and group 2 included patients who underwent delayed LC after 2 months. In group 1, patients were further divided into subgroups: LC either at the beginning (subgroup A) or after bariatric surgery (subgroup B).

Results: Operative time in group 1 vs. 2 was 92.63 ± 28.25 vs. 68.33 ± 17.49 (p < 0.001), and in subgroup A vs. B, it was 84.19 ± 19.62 vs. 130.0 ± 31.62 (p < 0.001). One patient in each group (2.6% and 8.3%) had obstructive jaundice, p > 0.001. In group 2, 33% of asymptomatic patients became symptomatic for biliary colic p > 0.001. LC difficulty score was 2.11 ± 0.70 vs. 5.66 ± 0.98 in groups 1 and 2, respectively, p < 0.001. LC difficulty score decreased in group 2 from 5.66 ± 0.98 to 2.26 ± 0.78 after 2 months of bariatric surgery, p < 0.001.

Conclusion: Timing for LC during bariatric surgery is challenging and should be optimized for each patient as scheduling difficult LC to be performed after 2 months may be an option.

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来源期刊
Journal of Obesity
Journal of Obesity ENDOCRINOLOGY & METABOLISM-
CiteScore
7.50
自引率
3.00%
发文量
19
审稿时长
21 weeks
期刊介绍: Journal of Obesity is a peer-reviewed, Open Access journal that provides a multidisciplinary forum for basic and clinical research as well as applied studies in the areas of adipocyte biology & physiology, lipid metabolism, metabolic syndrome, diabetes, paediatric obesity, genetics, behavioural epidemiology, nutrition & eating disorders, exercise & human physiology, weight control and health risks associated with obesity.
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