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IBD: 胆囊切除术对克罗恩病患者长期疾病结局和生活质量的影响

2020-05-03 MedSci原创 MedSci原创

胆囊切除术(CCY)是最常进行的腹部手术之一。但是,CCY在改变胃肠道生理和解剖结构(例如克罗恩病(CD))的影响尚未得到充分表征。

背景及目的: 胆囊切除术(CCY)是最常进行的腹部手术之一。但是,CCY在改变胃肠道生理和解剖结构(例如克罗恩病(CD))的影响尚未得到充分表征。本项研究试图探究CCY后CD患者的临床结局,疾病严重程度和生活质量。

方法: 研究人员利用了CD患者的前瞻性纵向登记数据库。接受或未接受CCY的克罗恩病患者组成两个研究组。常规护理期间进行的腹部CT扫描证实了胆囊的不存在或存在。收集并分析了多年的临床,生化和组织学数据并进行比较。

结果: 在834名CD患者中,有151名(18%)进行了CCY。CCY的病史与更高的疾病活动性(中位数Harvey-Bradshaw指数;P<0.001),更长的贫血年数(P= 0.048),较低的白蛋白(P= 0.001),生活质量差(P<0.001),慢性腹痛(P<0.001),发生结肠不典型增生的风险更高(P= 0.011),每年住院率更高(P= 0.004),阿片类药物的使用率(P<0.001)有关。在多变量分析中,CCY仍与较高的疾病活动性相关(P<0.001),较低的白蛋白相关性(P= 0.008),较低的生活质量(P<0.001)和更多的住院治疗(P= 0.008)有关,而患有回肠病的CD患者发生结肠发育不良的风险较高(P= 0.031)。

结论: CD患者的CCY与多年随访期间疾病活动和生活质量较差的多个指标相关。这些数据表明,CD患者的CCY可能会对长期临床过程产生不利影响。

原始出处:

Filippos Koutroumpakis. Et al. The Impact of Cholecystectomy on Long-Term Disease Outcomes and Quality of Life in Patients with Crohn’s Disease. Inflammatory Bowel Diseases.2020.

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