肝癌患者行切肝合併膽囊切除手術後腹瀉之危險因子探討

Risk Factors of Diarrhea after Cholecystectomy and Hepatectomy in Patients with Hepatocellular Carcinoma

患者在接受膽囊切除手術後腹瀉的發生率甚高，並影響患者術後的生活品質，本研究在探討肝細胞癌行肝葉併膽囊切除術後發生腹瀉盛行率之危險因子探討。研究採回溯性設計，單一醫學中心，從2005年01月至2015年08月共有209位符合納入。腹瀉診斷為每天解大於等於三次水便，一週發生三次以上。分為腹瀉及無腹瀉兩組並追蹤至術後三個月，分析術後腹瀉之重要危險因子。多變量邏輯迴歸分析術後 三個月腹瀉的重要危險因子亦為糖尿病（OR=19.355，95%信賴區問=2.992-125.203，p=0.002）。接受切肝合併膽囊切除手術後有糖尿病病史出現腹瀉情形應更須注意其生活品質。

High frequency of diarrhea has been found in patients with cholecystectomy. Diarrhea has a significant impact on quality of life among patients who have undergone cholecystectomy. Herein, we aim to investigate prevalence and risk factors of diarrhea after incidental cholecystectomy during hepatectomy in patients with hepatocellular carcinoma (HCC). This is a retrospective study and patients who underwent incidental cholecystectomy after hepatectomy between January 2005 and August 2015 at a single medical center were enrolled. A total of 209 cases were included in the study. Diarrhea was defined as the passing of three or more liquid stools per day. All patients were divided into two groups, patients with and without diarrhea at the time point of three months after incidental cholecystectomy during hepatectomy. Multiple logistic analysis revealed that history of diabetes (OR = 19.335, 95% CI: 2.992–125.203, p=0.002) at three months is risk factor associated with diarrhea after incidental cholecystectomy during hepatectomy. In order to reduce the risk of postoperative diarrhea and to enhance the quality of life in HCC patient with diabetes, long term follow up of nutritional status and liver function is also suggested.