Donald J J, Fache J S, Burhenne H J
Department of Radiology, University of British Columbia, Vancouver General Hospital, Canada.
AJR Am J Roentgenol. 1991 Aug;157(2):287-90. doi: 10.2214/ajr.157.2.1853808.
We perform biliary lithotripsy without adjuvant chemolitholytic agents, and therefore fragment clearance depends solely on the gallbladder's ability to evacuate its contents. We studied 205 patients to determine if gallbladder contractility before biliary lithotripsy is a predictor of treatment results and rate of fragment clearance. Percentage gallbladder contraction was calculated from the fractional difference in the sonographically measured gallbladder volumes before and after a fatty meal. Seventy-six patients (37%) were free of stones and fragments, and 129 patients (63%) had residual fragments at comparable follow-up intervals. Statistical analysis showed a significant difference in gallbladder contractility before biliary lithotripsy between the fragment-free group and the residual-fragment group (p = .008). Stone burden before treatment showed no significant difference between the groups (p = .074), but the number of stones was significantly less in the fragment-free group (p = .022). In the fragment-free group, a poor correlation (r = .047) was found between the percentage gallbladder contraction and the rate of fragment clearance. These data indicate that contractility of the gallbladder before treatment correlates with overall success of biliary lithotripsy but is not a predictor of the speed of fragment clearance.
我们在不使用辅助化学溶石剂的情况下进行胆石粉碎术，因此碎片清除完全取决于胆囊排空其内容物的能力。我们研究了205例患者，以确定胆石粉碎术前胆囊收缩性是否是治疗结果和碎片清除率的预测指标。胆囊收缩百分比通过超声测量的脂肪餐后胆囊体积的分数差异来计算。在可比的随访间隔期，76例患者（37%）无结石和碎片，129例患者（63%）有残留碎片。统计分析显示，无碎片组和残留碎片组在胆石粉碎术前的胆囊收缩性存在显著差异（p = 0.008）。治疗前结石负荷在两组之间无显著差异（p = 0.074），但无碎片组的结石数量显著较少（p = 0.022）。在无碎片组中，胆囊收缩百分比与碎片清除率之间的相关性较差（r = 0.047）。这些数据表明，治疗前胆囊收缩性与胆石粉碎术的总体成功率相关，但不是碎片清除速度的预测指标。
