「腹腔鏡膽囊切除手術」後,可能因膽汁不足以消化高油脂食糜,膽酸吸收不良,大腸蠕動速率增加,腸路徑縮短等結果,導致「腹瀉」;然而,「腹腔鏡膽囊切除手術」後「腹瀉」導因,實則具有多面向特性,術後「腹瀉」雖可能直接源自於「腹腔鏡膽囊切除手術」的結果,也可能源自於「非腹腔鏡膽囊切除手術」的其他相關因素,包括:術後「高脂飲食」、「術前腹瀉排泄型態」、「人格特質」、「腸胃道問題」、「致腹瀉藥物」、「飲食不衛生」等致腹瀉因子。本文主旨在提供醫護人員瞭解,「腹瀉」實為各種疾病類別中的一項徵兆,絕非單一疾病。當醫療或照護「腹腔鏡膽囊切除手術」後「腹瀉」病患同時,仍應審慎評估,排除各種可能之相關致腹瀉因子,不應將「腹瀉」局限於「腹腔鏡膽囊切除手術」後併發症的唯一結果,致漠視其他可能病情或相關致「腹瀉」因素。
Literature review revealed patients undergoing laparoscopic cholecystectomy diarrhea may be multifactorial, and most studies just investigate the complications and incidence instead of the associated factors of diarrhea in post laparoscopic cholecystectomy patients. Post laparoscopic cholecystectomy diarrhea may be caused by bile-insufficiency, bile acid malabsorption, gut transit shortening by accelerating colonic passage. And it may also be caused by high fat diet after laparoscopic cholecystectomy, preoperative diarrhea, personality disorders, gastrointestinal disorder, drug- induced diarrhea, or bacterial pathogens. In clinic practice, when encountering post laparoscopic cholecystectomy diarrhea, physicians and nurses should evaluate, confirm and pay much attention to each possible factor. To find the real factor is the best strategy for the treatment of post laparoscopic cholecystectomy diarrhea.