Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jun 16, 2024; 16(6): 318-325
Published online Jun 16, 2024. doi: 10.4253/wjge.v16.i6.318
Analysis of quality of life in patients after transgastric natural orifice transluminal endoscopic gallbladder-preserving surgery
Min-Yu Zhang, Sen-Yuan Zheng, Zheng-Yu Ru, Zhi-Qiang Zhang
Min-Yu Zhang, Sen-Yuan Zheng, Zheng-Yu Ru, Zhi-Qiang Zhang, Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urimuqi 830011, Xinjiang Uygur Autonomous Region, China
Author contributions: Zhang MY drafted the manuscript; Zhang MY and Zheng SY collected data; Zheng SY revised the manuscript; Ru ZY analyzed the data; Zhang ZQ designed the research; All authors issued final approval for the version to be submitted.
Institutional review board statement: The study was reviewed and approved by The First Affiliated Hospital of Xinjiang Medical University Institutional Review Board (No. K202311-33).
Informed consent statement: Informed written consent was waived by The First Affiliated Hospital of Xinjiang Medical University Institutional Review Board.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Dataset available from the corresponding author at drzhiqiang@163.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Qiang Zhang, MD, Chief Physician, Professor, Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, No. 137, Liyushan Road, New Urban Area, Urimuqi 830011, Xinjiang Uygur Autonomous Region, China. drzhiqiang@163.com
Received: December 28, 2023
Revised: February 15, 2024
Accepted: May 7, 2024
Published online: June 16, 2024
Processing time: 168 Days and 16.1 Hours
Abstract
BACKGROUND

At present, laparoscopic cholecystectomy (LC) is the main surgical treatment for gallstones. But, after gallbladder removal, there are many complications. Therefore, it is hoped to remove stones while preserving the function of the gallbladder, and with the development of endoscopic technology, natural orifice transluminal endoscopic surgery came into being.

AIM

To compare the quality of life, perioperative indicators, adverse events after LC and transgastric natural orifice transluminal endoscopic gallbladder-preserving surgery (EGPS) in patients with gallstones.

METHODS

Patients who were admitted to The First Affiliated Hospital of Xinjiang Medical University from 2020 to 2022 were retrospectively collected. We adopted propensity score matching (1:1) to compare EGPS and LC patients.

RESULTS

A total of 662 cases were collected, of which 589 cases underwent LC, and 73 cases underwent EGPS. Propensity score matching was performed, and 40 patients were included in each of the groups. In the EGPS group, except the gastrointestinal defecation (P = 0.603), the total score, physical well-being, mental well-being, and gastrointestinal digestion were statistically significant compared with the preoperative score after surgery (P < 0.05). In the LC group, except the mental well-being, the total score, physical well-being, gastrointestinal digestion, the gastrointestinal defecation was statistically significant compared with the preoperative score after surgery (P < 0.05). When comparing between groups, gastrointestinal defecation had significantly difference (P = 0.002) between the two groups, there was no statistically significant difference in the total postoperative score and the other three subscales. In the surgery duration, hospital stay and cost, LC group were lower than EGPS group. The recurrence factors of gallstones after EGPS were analyzed: and recurrence was not correlated with gender, age, body mass index, number of stones, and preoperative score.

CONCLUSION

Whether EGPS or LC, it can improve the patient’s symptoms, and the EGPS has less impact on the patient’s defecation. It needed to, prospective, multicenter, long-term follow-up, large-sample related studies to prove.

Keywords: Gallstones; Natural orifice transluminal endoscopic surgery; Gallbladder preservation; Cholecystolithotomy; Laparoscopic cholecystectomy; Gastrointestinal quality of life index

Core Tip: Laparoscopic cholecystectomy (LC) is now the gold standard for treating gallstones. However, long-term complications of LC such as postcholecystectomy syndrome, bile duct injury, intestinal dysbiosis, tumor may occur. Some experts want to remove the gallstones while preserving the function of the gallbladder, natural orifice transluminal endoscopic surgery came into being. This study compared transgastric natural orifice transluminal endoscopic gallbladder-preserving surgery with traditional LC.