Nawroth R, Batsch M
Klinik für Chirurgie, Humboldt-Universität, Berlin.
Zentralbl Chir. 1991;116(5):311-8.
Secondary bile acids act as co-carcinogens during genesis of colo-rectal carcinomas. That implies the question wether the patient's situation after cholecystectomy, which is characterized by an increased content of secondary bile acids in the whole pool and a raised intestinal circulation, supports the growth of colo-rectal carcinomas or not. We retrospectively analysed the anamnesis of 189 patients suffering from colorectal carcinomas and found a significantly increased number of cholecystectomized people in comparison with a Berlin normal population according to an autopsy study. The relative risk for the whole colon and rectum amounted to 1.53 and for proximal colon to 2,1. The connection between cholecystectomy and colorectal carcinomas seems to be not close enough to define risk groups. However, it entitles to demand the very consequent observance of indication of cholecystectomy and to take alternative therapies for maintenance of gallbladder always into consideration.
继发性胆汁酸在结直肠癌发生过程中作为促癌剂。这就引出了一个问题，即胆囊切除术后患者的情况（其特征是整个胆汁池中继发性胆汁酸含量增加以及肠循环增强）是否支持结直肠癌的生长。我们回顾性分析了189例结直肠癌患者的病历，根据一项尸检研究发现，与柏林正常人群相比，胆囊切除者的数量显著增加。整个结肠和直肠的相对风险为1.53，近端结肠为2.1。胆囊切除术与结直肠癌之间的联系似乎不够紧密，无法界定风险群体。然而，这使得我们有必要严格遵守胆囊切除术的指征，并始终考虑采用替代疗法来保留胆囊。
