Patel Nilesh A, Lamb Jason J, Hogle Nancy J, Fowler Dennis L
Department of Surgery, Allegheny General Hospital, Pittsburgh, PA, USA.
Am J Surg. 2004 Feb;187(2):209-12. doi: 10.1016/j.amjsurg.2003.11.027.
The outcome of laparoscopic cholecystectomy for patients who present with "classic" biliary colic without evidence of cholelithiasis or acute inflammation (biliary dyskinesia) is not well documented. This study evaluates whether a cholecystokinin dimethyl iminodiacetic acid (CCK-HIDA) scan can predict relief of symptoms in this group of patients.
Patients who underwent laparoscopic cholecystectomy after a normal ultrasound and with an abnormal dimethyl iminodiacetic acid scan were retrospectively reviewed. Symptomatic improvement was correlated with degree of dyskinesia, histologic findings, sex, and age.
One hundred seventy-six patients were studied and 69% were available for followup at a mean interval of 16 months. One hundred fourteen patients (94%) had complete or partial relief of symptoms. No correlation was found between degree of relief and degree of impaired ejection (31% to 50% versus <30%), the histologic findings, sex, or age.
Abnormal cholecystokinin dimethyl iminodiacetic acid scan effectively predicts relief of symptoms in patients undergoing laparoscopic cholecystectomy for biliary dyskinesia.
对于表现为“典型”胆绞痛但无胆石症或急性炎症证据(胆囊运动障碍)的患者,腹腔镜胆囊切除术的结果尚无充分记录。本研究评估胆囊收缩素二甲基亚氨基二乙酸(CCK-HIDA)扫描能否预测该组患者症状的缓解情况。
对超声检查正常且二甲基亚氨基二乙酸扫描异常后接受腹腔镜胆囊切除术的患者进行回顾性研究。症状改善与运动障碍程度、组织学检查结果、性别和年龄相关。
共研究了176例患者,69%的患者可进行随访,平均随访间隔为16个月。114例患者(94%)症状完全或部分缓解。缓解程度与射血受损程度(31%至50%对<30%)、组织学检查结果、性别或年龄之间未发现相关性。
异常的胆囊收缩素二甲基亚氨基二乙酸扫描能有效预测因胆囊运动障碍接受腹腔镜胆囊切除术患者的症状缓解情况。