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[非结石性胆囊疾病的放射临床与形态学比较]

[Radioclinical and morphological comparisons in non-lithiasic gallbladder diseases].

作者信息

Voicu F, Voicu L, Laky D, Poenaru D, Gabrovescu D

出版信息

Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir. 1975 Mar-Apr;24(2):123-9.

PMID:127208
Abstract

Confrontation of the clinical, radiologic and morphologic data in a lot of 274 patients operated for non-lithiasic cholecystopathies during the 1966-1972 period, led to the following conclusions: - the painful choleic syndrome whose duration and frequency increase progressively, refractory to the conservative treatment, is a basic criterion in establishing the surgical treatment; - any change in the radiologic image of the gallbladder, especially those evoking a partial or totally inefficient contractile effort are of diagnostic value, suggesting the necessity of the operation, when confirmed by a similar clinical context; - the morphologic substrate consists in inflammatory lesions (infiltrations, atrophy of the mucosa, sclerosis), or degenerative lesions (cholecystoses) due to the reaction of the gallbladder walls to the irritative-chemical action of the bile hyperconcentrated by intermittent stasis caused by an incomplete cystic obstacle; - both types of lesions may determine with time obstruction of the cystic duct (acute cholecystitis), changes in the choledochoduodenal confluence (odditis), co-affection of the pancreas and liver (cholecystopancreatitis, chronic reactive hepatitis); - the late results lend support to the surgical treatment in such circumstances.

摘要

对1966年至1972年间因非结石性胆囊疾病接受手术的274例患者的临床、放射学和形态学数据进行对比分析后,得出以下结论:

  • 疼痛性胆绞痛综合征,其持续时间和发作频率逐渐增加,对保守治疗无效,是决定手术治疗的基本标准;

  • 胆囊放射影像的任何改变,尤其是那些提示胆囊收缩功能部分或完全丧失的改变,具有诊断价值,若有相似的临床情况证实,则提示有手术必要;

  • 形态学基础包括炎症性病变(浸润、黏膜萎缩、硬化),或因胆囊壁对由不完全胆囊梗阻导致的间歇性胆汁淤积引起的高浓缩胆汁的刺激化学作用产生的退行性病变(胆囊病);

  • 随着时间推移,这两种病变都可能导致胆囊管梗阻(急性胆囊炎)、胆总管十二指肠汇合处改变(奥迪氏括约肌炎)、胰腺和肝脏并发疾病(胆囊胰腺炎、慢性反应性肝炎);

  • 在这种情况下,手术治疗的远期效果证实了其合理性。

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