Quality of life of patients with gallstone disease and gallbladder cholesterosis in the conservative and surgical treatment
Ivanchenkova, R.A.; At'kova, E.R.
Eksperimental'naia i Klinicheskaia Gastroenterologiia 5: 46-55
2012
ISSN/ISBN: 1682-8658 PMID: 23402171 Document Number: 662467
to investigate the quality of life of patients with gallstone disease and gall bladder cholesterosis on a background of conservative therapy and after surgery. the study involved 60 patients with GSD and GBC treated conservatively, 75 patients with GSD and GBC treated surgically, the control group - 35 men aged of 20,6 +/- 1,2. A survey using questionnaires GIC, SF-36, ultrasound, radiography, CT of the abdomen, cholecystography, examined the range of blood lipids. reduction in QOL in the CL was detected in 92.8% of patients on all scales, progressing during the exacerbation of the disease (58.3%). The overall QOL score was reduced (up to 92,5 +/- 7,0) when compared with CG (346,7 +/- 8,2, p <0,001) and the maximum score (410.0). Conservative therapy improves the QOL of patients with gallstone disease in 50.7% of cases at all scales. The overall score increased to 155,9 +/- 5,6, p < 0,001, but remained lower than in the CG. When GBC reduced QOL was found in 75.8% of patients on all scales, progressing during the exacerbation of the disease (40.8%). Contact of worsening QOL with the duration of relapse stable disease (p < 0,001). Conservative therapy improves the QOL of patients with GBC in 54.1% of cases at all scales. The overall score has increased from 51,9 +/- 5,5 to 135,1 +/- 2,6 (p< 0.001), but remained lower than in the CG. QOL of patients with GSD and GBC reduced by all indicators, the GSD to a greater extent. In patients with GSD main factors reducing the QOL are pain (34.5% and 100% in the period of exacerbation of the disease) and non-use of previously familiar food (62.0%) because of fear of pain attack at GBC - emotional quotient (66.9% - thought about the inevitability of surgery and the possibility of malignancy). When GSD QOL of patients before CE decreased (93.6%) to a greater extent than in patients prior to conservative treatment due to the pain factor (65.4%), total score amounted to 86,4 +/- 5,1 and 92,5 +/- 7,0, respectively, p <0.05. The main factors of nuclear explosion-QOL differences were pain attacks (65.4% and 35.7%) and emotional quotient. The factors of higher-QOL after the CE (59.1%) are the elimination of pain attack (100%), normalization of stool. The total score improved from 86,4 +/- 5,1 to 128,4 +/- 6,3, p <0,001, but remained lower than in the CG (p <0,001) and a comparison with the highest scores (p < 0,001). When GBC quality of life of patients before CE decreased (95.1%) to a greater extent than in patients prior to conservative treatment (75.8%) due to emotional factors: the thought of the possibility of malignancy. The total score was 40,2 +/- 5,3 and 51,9 +/- 5,5, respectively, p<0.05. Surgical treatment improves QOL of patients with GBC (61.8%) in all major scales. The total score improved from 40,2 +/- 5,3 to 122,6 +/- 6,0, p < 0,001, but remained lower than in the CG (p < 0,001) and a comparison with the highest scores (p < 0,001). the results allow us to recommend a conservative therapy for cholelithiasis patients as a method of choice in the presence of indications for its place-of. The determining factor is the density of lithotherapy concrement, as measured by CT. In case of impossibility of conservative therapy should prompt surgical treatment of cholelithiasis before the development of irreversible changes in the organs of hepato-pancreatoduodenal system.