Quality of Life of the Patients Undergone Different Types of Cholecystectomy

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1 ОЗЗО ЛЕИНИРЕҐЩЙДВГ РЩКО ВВРЕЕ, 2003, 8, 1, 7279 ъ (ЪДП) [5, 10, 14, 20] А - ъ - А И [5, 14] Й ЪДП ъ - [3, 5,13, 14, 20, 23, 35, 49],, ъ, - ъ - ( Д ъ ъ 1 К Й А, Д Щ Ґ, Е Е, М О Х М ЗЗ П ( ИОЖЗ Ц Х- ) Ж Ж- О ЕЖ Й- Иъ, ( ЛЧ), - (ЙЛЧ), (ЖЛЧ) Е ъ О-, ъ ъ, -, -, - К ЛЧ - (ЙЛЧ, ЖЛЧ) 3 - Ч ъ ъ, ъ -, ЛЧ О, -, ЙЛЧ ЖЛЧ, ъ -, ъ - ъ, ъ- Quality of Life of the Patients Undergone Different Types of Cholecystectomy P S Vetshev, K E Chilingaridi, LI Ippolitov, FA Shpachenko NN Burdenko Faculty Surgical Clinic (Dir Akademician RAMsci YuL Shevchenko), IM Sechenov Moscow Medical Academy The paper is dedicated to investigation of short-term and long-term results in three groups of patients undergone routine cholecystecromy (RCE), laparoscopic cholecystectomy (LCE) or cholecystectomy using minimal laparotomy approach (MCE) The long-term results study was based on estimation of quality of life of patients as the most coincident criterion Intraoperative and post-operative morbidity rate analysis revealed, that in high volume centers, where the surgeons had already passed the stage of developing of minimally invasive technique, this rate was much more lower than average data Significant difference in the quality of life of patients undergone RCE or minimally invasive procedures (LCE, MCE) disappeared only 3 years after surgical therapy It was due to the longer period of rehabilitation patients after RCE needed for full physiological and psychological adaptation The quality of life index integral module analysis revealed that patients undergone LCE or MCE significantly rapidly returned to their usual social and intellectual activities, gave higher values to their health and well-being conditions, and so had the better quality of life 1 А А ъ- Ъ ъ Ч ъ - - АЛ А (1969 ) - К, 1015% 1 Й - ъ 2425 ъ 2001, Ж 72

2 АЩ ХЩА, ) ъ- ъ - - [1, 6, 8, 47, 52] В,, -, ( -, ъ 1 : 1), ъ, -, - ЪДП,, [3, 13, 20, 22, 37, 39, 41, 4446, 49] Й - -,,, 512% [8, 24] Й - - ъ - ЪДП Й (C Langenbuch) ъ - ЪДП В -,,, ъ -, ъ - ъ -, ъ, - ъ [6, 27, 29, 30, 36] - -,, ъ, -, -, - ъ - [1, 28, 42, 47, 53, 55] К -, ъ ъ, ъ, - - [10, 16, 27, 28, 42, 55] Е,, ъ,, - ъ ( - ъ,, ъ- ), [4, 30, 31, 38, 48] Е АВ - - :, - - [2, 51, 53] К ъ - ъ -, ъ, ъ, -, ъ ъ- [2, 7, 12, 53, 54] А, -, [6, 15, 18, 38] Ж - ъ-, ъ [6, 19, 43, 53] О,, - ъ ъ-, ъ - ( ъ ) - -, - ъ А - ъ, - - К -, ЪДП, -,, А - - ъ Ж Й ъ -, 3 -, - ( ЛЧ) 95 (1- ), (ЙЛЧ) 91 (2- ), - (ЖЛЧ) 92 (3- ), - ъ - ЗЗ П (МЛД) [9] - ъ [6, 31, 33, 47] Ч ъ ОЗЗО ЛЕИНИРЕҐЩЙДВГ РЩКО ВВРЕЕ

3 ДОҐЩЙ АВ ЪЕ ЗЕ ПВ ЗЛ ъ 1 Ґ ъ ( %) ъ Й ъ Р ъ ЛЧ ЙЛЧ ЖЛЧ Е ъ К З О Р ъ IIII К В IIIII , Й ъ - ъ - (ОХ) В Р ъ, ъ (ъ 1) А ъ 23 79, с 31, с 41, с 44 Аъ А ъ А ъ ъ - - (70, 80 74% 1, 2 3- ), ъ- ъ - - ъ, - ъ ъ Й ЛЧ 816 с 33, ЙЛЧ 617 с с 42, ЖЛЧ 475 с 35 - ЛЧ 143 с 17, ЖЛЧ 38 с 04, ЙЛЧ - ъ (1012 ) - 4 ( ) Е - [21, 25], - ъ А ъ - ( ) [21] В - - ъ К ъ, -,, -,, ъ А - -, ъ ъ, -, - А - -, ъ ъ ъ ъ Й, - ъ - ъ, А -, -,,, ъ- ъ [9, 29, 34, 56] Н : 72%, - 15%, - ъ 13%, ъ [6, 17, 31, 33, 42, 47] А,, -, ъ-, ъ- ъ [11, 26, 50] Д, ъ - - ъ [37] А - 5- RLikert [40]: -,,,,, 1 5 ъ Д,, -, ъ 74 ОЗЗО ЛЕИНИРЕҐЩЙДВГ РЩКО ВВРЕЕ

4 АЩ ХЩА Р- ъ, -, ъ 0 60,, -, Н ъ ъ ъ ОХ, - 200, : -, ( - ), ъ (- ) З ъ ( ), ъ В- ОХ ъ, - [32, 55] И ъ З - - ( - ) Е ъ 18% ъ П - ъ ЙЛЧ (11%) А ЖЛЧ ЛЧ - (04 03%) К 22% ъ, ъ ЛЧ 16% А ЙЛЧ ЖЛЧ 04% З, - ъ ъ - 3 ( с 32, с 27, с 36 ; < < 0005), - К ъ :, - ЙЛЧ ЖЛЧ, ъ 6 ъ, с с 221,,, - ЛЧ, 9961 с 917 ( < 005) ъ 2 К (ЕДЪ, ОХ) Р ЕДЪ, ОХ, ЛЧ 434 с с с 95 ЙЛЧ 467 с с с 103 ЖЛЧ 413 с с с 97 К: ЕДЪ И, - ОХ, - ЪДП (ъ 2) Д ЕДЪ ОХ r = 083 (p = = 00001) Н, - ЛЧ, ъ 3, - ( - ) ( 1) Зъ -, - ЛЧ, 6 ъ, ( - ) К - ЛЧ ъ ъ-, ъ, - ъ ( 2) p 1,2/3 < p 1,2/3 < 005 p 1,2/3 > 005 ЛЧ 1 ЖЛЧ 2 ЛЧ 3 И 1 Д ъ - - ОЗЗО ЛЕИНИРЕҐЩЙДВГ РЩКО ВВРЕЕ

5 ДОҐЩЙ АВ ЪЕ ЗЕ ПВ ЗЛ (a) p 1,2/3 < (ъ) 6 p 1,2/3 < 005 ЛЧ 1 ЖЛЧ 2 ЛЧ 3 Ч Й А Е Ч М А И 2 Д ъ 6 -, ъ О, ( ъ,, ъ ъ, - ), -, ЛЧ ( 2ъ) В ъ ъ ъ ЛЧ ( -,, - ),, ъ ъ-, (ъ 3) К Й ъ ЛЧ ЛЧ ЖЛЧ И 3 К ъ ( % - ) Д 15, - ЛЧ,, ъ Д 3, ЛЧ, ъ ( 3) К -, ъ, ЛЧ -, ъ - ъ 3 Д К А ЛЧ ЙЛЧ ЖЛЧ p 1 p 2 p 3 ЕДЪ МЛД 9961 с с с 221 <0001 <0001 >005 Е ** <0001 <001 >005 Ч ** <0001 <001 <0001 М ** <0001 <0001 <001 А ** <0001 <0001 >005 Й ъ** <0001 <0001 >005 К ** <0001 <001 <001 Й ** <0001 <001 >005 Ч ъ** <0001 <0001 >005 А ** <0001 <0001 >005 * А ** А % К: p 1 ЛЧ/ЙЛЧ; p 2 ЛЧ/ЖЛЧ; p 3 ЙЛЧ/ЖЛЧ 76 ОЗЗО ЛЕИНИРЕҐЩЙДВГ РЩКО ВВРЕЕ

6 АЩ ХЩА,, ъ, - А ЛЧ ъ 3, ЛЧ, - ( 5324 с с 19 ), - ( 522 с с 15 ) ъ ( 634 с с 21 ) ъ ъ - А ъ 4 : 1-75, , , Н, -,, Д - 176%, ъ- К ъ - ъ - В, ъ ъ с 37 (r = 0124),, - ъ - ъ-, - ЪДП ъ,, -, Ґ -, ъ - ъ,, -, В - -, ЙЛЧ ЖЛЧ, О - ъ - ъ ъ, ЛЧ ЖЛЧ,, - ъ, - ъ ЪДП - ъ ъ , -, ЛЧ -, - Ч ъ ъ, ъ, ЛЧ Й 1 А КЙ, Ґ ДЩ, Е Е Л - ъ // Д Й By XB Въ ъ Щ ъ АВ Д-, 1985 Й Р ЧЕ, Д ЗМ Иъ ъ // Л Й Р ОР, АК, О Ж, Х- ЖР // Д Й ЙО, А КЙ, Х ОЖ, К- ЖЕ Ъ ъ Ж, Ц В - ъ // Й Й Д Л Д ъ - - О Ж, Д ЩО Ж- - ъ ъ, ъ О- -, Ж, Д ЗЗ Д ъ ъ О - Ж, Д ЖЕ,Хъ ВЙ, А КЙ Д- - - ъ // Д Й Ж BC // Д Й Ж ЕЙ, Д АЕ, Е ЩЗ Й Ж, З ЖЩ, Й ОА ъ - ОЗЗО ЛЕИНИРЕҐЩЙДВГ РЩКО ВВРЕЕ

7 ДОҐЩЙ АВ ЪЕ ЗЕ ПВ ЗЛ // О Й Въ 9- Ж- ъ ъ // Ж Й К ЗЕ Въ ъ // Й К BC В А, 8-: Д Й К АК, // Д Й Й ВП, К Й Д ъ ъ - - // Д Й Й О, К ЩО, ЙА В ъ ъ ъ - // Д Й М ЕА, Й ЩЕ, В АА // Ч Й Х МО А - ъ О Ж, Archer SB, Brown DW, Smith CD, Branum GD, Hunter JG Bile duct injury during laparoscopic cholecystectomy: results of a national survey // Ann Surg 2001 V P Azagra JS, De Simone P, Goergen M Is there a place for laparoscopy in management of postcholecystectomy biliary injuries? // WJS 2001 V P Black NA,Thompson E Group symptoms and health status before and six weeks after open cholecystectomy // European cohort study Gut P Bland JM, Altaian DG Statistical methods for assessing agreement between two methods of clinical measurement // Lancet 1986 P Bulent Mentes B, Akin M, Irkorucu O, Tatlicioglu E, Ferahkose Z, Yildinm A, Maral I Gastrointestinal quality of life in patients with symptomatic or asymptomatic cholelithiasis before and after laparoscopic cholecystectomy // Surg Endosc 2001 V P Eypasch E, Troidi H, Wood-Dauphinee S et al Quality of life and gastrointestinal surgery a clinimetric approach to developing an instrument for its measurement // Theor Surg P Eypasch E, Williams JI, Wood-Dauphinee S et al Gasrtointestinal quality of life index : development, validation and application of a new instrument // Br J Surg 1995 V 82 P Felce D, Perry J Quality of life : its definition and measurement // Res Dev Disabil 1995 V 16 1 P Guyatt GH A Taxonomy of Health Status Instruments // J Reumatol 1995 V 22 P Guyatt GH Measuring health-related quality of life in heart failure // Irish J Psychol 1994 V 15 1 P Hoffman LG, Rouse MW, Brin BN Quality of life: a review // J Am Opton Assoc 1995 V 66 5 P Hollander F The insulin test for the presence of intact nerve fibers after vagal opezation for peptic ulcer // Gastrotnterol 1998 V P Hunt RH Quality of life the challenges ahead // Scand J Gastrornterol 1993 V P Huttl TP, Hrdina C, Kramling HJ, Schildberg FW, Meyer G Gallstone surgery in German university hospitals Development, complications and changing strategies // Langenbecks Arch Surg 2001 V P Ingelfinger FJ The chemistry of the American indions burden // N End L Med 1979 V P Kaplan RM, Feeny D, Revicki DA Methods for assessing relative 1 importance in preference based outcome measures Quality of life Eds ShumakersA,Berzon R - Rapid Communications Oxford, 1995 P Kerr GD Quality of life personal view // Scand J Gastroenterol 1993 V 28 l99 P Krahenbuhl L, Sclabas G, Wente MN, Schafer M, Schlumpf R, Buchler MW Incidence, risk factors, and prevention of biliary tract injuries during laparoscopic cholecystectomy in Switzerland // WJS 2001 V P Likert R A technique for measurement of attitudes // Arch Psychol P McMahon AJ, Fullarton Q Bile duct injury and bile leakage in laparoscopic cholecystectomy // Br J Surg P Petersen H What do we miss with the traditional efficacy, safety evaluation? // Scand J Gastroenterol 1993 V P Quality of medical care Theory, practice, evolution Ed NO Graham London Churchill Livingstone, 1996 P Regoly-Merei J Ihasz M Billiary tract complications in laparoscopic cholecystectomy // SurgEndosc P Robin S, McLeod MD Quality of Life of Patients with Inommatory Bowel Disease after Surgery // WJS 1998 V 22 P Sawyers IL Current status of conventional (open) cholecystectomy versus laparoscopic cholecystectomy // Ann Surg 1996 V P Spiegelhater D, Gore SM, Fitzpatrick R et al Quality of life measures in health care // Br Med J 1992 V 305 P Spitzer WO State of science 1986: quality of life and functional status as target variables for research // J Chron Dis P ОЗЗО ЛЕИНИРЕҐЩЙДВГ РЩКО ВВРЕЕ

8 АЩ ХЩА 49 Sportelli G, Crovaro M, Mercuri M, Carrara A, Giri S, Fiocca F Conservative approach in the treatment of the biliary tracts iatrogenic lesions // Eur Rev Med Pharmacol Sci 2000 V 4 56 P Sue-Ling H, Young S, Griffith J, Johnston D Quality of life after radical (D2) recection for gastric cancer: results of a long-term follow-up study // Br J Surg 1996 V 83 P Thybush-Bernhardt A, Schmidt CS et al Quality of life following radical surgical treatment of gastric carcinoma // WJS P Troidl H Quality of life Berlin: Springer Verlag, 1993 P WHO Meeting of investigations on quality of life Geneva, P WHOQOL Group Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL) QualLife Res P Wood Й Are happy people healthier? Discussion paper // J RoySoc Med 1987 V 80 6 P Wood-Dauphinee SL Assessing quality of life in surgical studies // Theor Surg : P 3544 ОЗЗО ЛЕИНИРЕҐЩЙДВГ РЩКО ВВРЕЕ

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