胆总管十二指肠吻合术后的十二指肠胃反流：通过锝-99m闪烁扫描术进行评估
Duodenogastric reflux after choledochoduodenostomy: evaluation by technetium-99m scintigraphy.
作者信息
Hashimoto Naoki, Yasuda Tikao, Inayama Masato, Ho Hidemine, Shinkai Masayuki, Kawanishi Kenshu, Hirai Norihiko, Imano Motohiro, Shigeoka Hironori, Imamoto Haruhiko, Shiozaki Hitoshi
机构信息
Department of Surgery, Kinki University School of Medicine, 377-2 Ohno-Higashi Osaka Sayama, Osaka, Japan.
出版信息
Hepatogastroenterology. 2007 Apr-May;54(75):796-8.
BACKGROUND/AIMS: Persistence of dyspeptic symptoms after choledochoduodenostomy (CDD) is common. There is evidence that at least some of these symptoms may be attributed to duodenogastric reflux (DGR). The aim of the study was to quantify DGR after CDD.
METHODOLOGY
A total of 6 patients who had undergone cholecystectomy with a standard side-to-end CDD for choledocholithiasis or Lemmel syndrome were studied by symptom evaluation, biliary scintigraphy and endoscopy at least 6 months after surgery. Duodenogastric reflux was quantified using continuous intravenous infusion of 99mTc-HIDA.
RESULTS
The incidence of DGR after CDD was 67% compared to healthy control. In the majority of the patients the DGR was mild to moderate, but not with the clinical symptoms.
CONCLUSIONS
99mTc-HIDA scanning of the hepatobiliary system is a reasonable and reliable method for the quantitative evaluation of DGR. CDD is associated with a high incidence of DGR, but its occurrence does not produce significant clinical symptoms.
背景/目的：胆总管十二指肠吻合术（CDD）后消化不良症状持续存在很常见。有证据表明，这些症状中至少有一些可能归因于十二指肠胃反流（DGR）。本研究的目的是量化CDD后的DGR。
方法
对6例因胆总管结石或莱姆综合征接受胆囊切除术并进行标准端侧CDD的患者，在术后至少6个月通过症状评估、胆道闪烁显像和内镜检查进行研究。采用持续静脉输注99mTc-HIDA对十二指肠胃反流进行量化。
结果
与健康对照相比，CDD后DGR的发生率为67%。大多数患者的DGR为轻度至中度，但与临床症状无关。
结论
肝胆系统的99mTc-HIDA扫描是定量评估DGR的一种合理且可靠的方法。CDD与DGR的高发生率相关，但其发生不会产生明显的临床症状。
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