腹腔镜胆囊切除术治疗胆囊运动障碍：术前胆囊收缩素胆囊闪烁显像结果与术后结局的相关性
Laparoscopic cholecystectomy for biliary dyskinesia: correlation of preoperative cholecystokinin cholescintigraphy results with postoperative outcome.
作者信息
Bingener J, Richards M L, Schwesinger W H, Sirinek K R
机构信息
Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7842, San Antonio, TX 78229-3900, USA.
出版信息
Surg Endosc. 2004 May;18(5):802-6. doi: 10.1007/s00464-003-8145-6. Epub 2004 Apr 2.
BACKGROUND
A gallbladder ejection fraction (EF) on cholescintigraphy of less than 35% after cholecystokinin (CCK) has been considered to be pathophysiologic and an indication for laparoscopic cholecystectomy (LC).
METHODS
All patients undergoing LC for biliary dyskinesia between 1994 and 2001 were prospectively entered into a database. These patients were retrospectively evaluated with regard to demographics, the number of preoperative studies obtained, postoperative symptoms, and the number of postoperative studies obtained.
RESULTS
Sixty patients underwent LC for biliary dyskinesia. The mean gallbladder EF was 14%, and 75% of patients were asymptomatic postoperatively. Persistent symptoms prompted further investigation in 6% of patients with a gallbladder EF <14% and in 35% of patients with an EF between 14 and 35% (p = 0.05).
CONCLUSION
Laparoscopic cholecystectomy alleviated symptoms in 94% of patients with a gallbladder EF <14% after CCK injection. The diagnostic significance of a preoperative CCK cholescintigram (EF 14-35%) needs further investigation.
背景
胆囊收缩素（CCK）激发后，胆囊闪烁造影术测得的胆囊排空分数（EF）低于35%被认为具有病理生理学意义，是腹腔镜胆囊切除术（LC）的指征。
方法
1994年至2001年间所有因胆囊运动障碍接受LC的患者均被前瞻性纳入数据库。对这些患者进行回顾性评估，内容包括人口统计学资料、术前检查次数、术后症状以及术后检查次数。
结果
60例患者因胆囊运动障碍接受了LC。平均胆囊EF为14%，75%的患者术后无症状。胆囊EF<14%的患者中有6%以及EF在14%至35%之间的患者中有35%因持续症状而接受进一步检查（p=0.05）。
结论
腹腔镜胆囊切除术使94%的CCK注射后胆囊EF<14%的患者症状得到缓解。术前CCK胆囊闪烁造影（EF 14 - 35%）的诊断意义需要进一步研究。
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