Gerbasi D, Santangelo M, Sommella L, Battaglia M, Triggiani D, Triggiani E
Clinica Chirurgica Generale, Policlinico Mater Domini, Università degli Studi, Catanzaro.
Minerva Chir. 1999 Dec;54(12):863-8.
On the basis of personal experience and literature, this study has been carried out in order to clarify the impact of ultrasonography on the diagnosis and prevention of hepatobiliary complications Total Parenteral Nutrition (TPN)-related.
Between April 1995-April 1997 in the Department of General Surgery-University of Catanzaro, 18 adult patients submitted to major thoracic or abdominal surgery, underwent to TPN for perioperative time (range: 9-55 days). In these patients ultrasonography was performed at pre-established days in pre- and postoperative time in order to diagnose precociously the possibility of hepatobiliary complications.
Ultrasonography showed: 3 cases of hepatic steatosis, 5 cases of steatosis and gallbladder biliary sludge, 2 cases of gallbladder biliary sludge alone, 1 case of gallbladder biliary sludge with microlithiasis, 1 case of acute acalculous cholecystitis. The other 6 patients presented only little laboratory tests alterations, but normal ultrasonographic findings.
Therefore it is underlined the importance of systematic ultrasonographic follow-up of patients on TPN as a non invasive method in the early diagnosis of hepatobiliary complications TPN-related. The good compliance of the patients to this instrumental investigation and the not excessive increase of their management's costs are also underlined.
基于个人经验和文献，开展本研究以阐明超声检查对全胃肠外营养（TPN）相关肝胆并发症的诊断和预防的影响。
1995年4月至1997年4月期间，在卡坦扎罗大学普通外科，18例接受大型胸腹部手术的成年患者在围手术期接受了TPN治疗（范围：9 - 55天）。在这些患者中，于术前和术后既定日期进行超声检查，以便早期诊断肝胆并发症的可能性。
超声检查显示：3例肝脂肪变性，5例脂肪变性合并胆囊胆汁淤积，2例单纯胆囊胆汁淤积，1例胆囊胆汁淤积合并微结石，1例急性非结石性胆囊炎。其他6例患者仅实验室检查有轻微改变，但超声检查结果正常。
因此强调了对接受TPN治疗的患者进行系统超声随访作为一种非侵入性方法在早期诊断TPN相关肝胆并发症中的重要性。还强调了患者对这种检查手段的良好依从性以及其管理成本不会过度增加。
