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[胃部不适还是胆囊切除术后综合征?]

[Gastric complaints or postcholecystectomy syndrome?].

作者信息

Galbfach Przemysław Jacek, Kołacińska Marta Bozenna, Flont Paweł Arkadiusz, Spychalski Michał Igor, Narbutt Piotr Gustaw, Mik Michal Lukasz, Dziki Łukasz Adam, Dziki Adam Janusz

机构信息

Uniwersytet Medyczny w Łodzi, Klinika Chirurgii Ogólnej i Kolorektalnej.

出版信息

Pol Merkur Lekarski. 2008 Sep;25(147):221-5.

Abstract

UNLABELLED

Postcholecystectomy syndrome (PCS) is a complex of symptoms from gastrointestinal tract that could develop and maintain after cholecystectomy. PCS usually consists of: abdominal pain or colic, dyspepsia, constipation or diarrhoea, nausea, bloating, fatty food intolerance. Regarding PSC as disease entity is still a point of many controversies.

THE AIM OF THE STUDY

To estimate the prevalence of PCS in patients after cholecystectomy performed in Department of General and Colorectal Surgery of Medical University in Lodz. Material and methods. From the cohort of 243 patients (pts) operated on due to symptomatic cholecystitis the group of 150 pts was surveyed. We included 86 pts who answered the questionnaire. The prevalence of PCS and intensity of symptoms were measured with the use of modified Gastrointestinal Symptoms Rating Scale (GSRS)--only 6 complaints commonly connected with pathology of biliary system were chosen (abdominal pain, rebounding, constipation, urgent diarrhea, nausea, bloating).

RESULTS

After cholecystectomy gastric complains were revealed in 32 pts (37.2%). In a group of 12 pts (13.9%) symptoms were noted at the same level of intense. However in 20 pts (23.25%) either more intense or appeared as brand new manifestation. Excessive amount of intestinal gases (93.75%) and bloating (87.5%) were the most common symptoms unlike abdominal pain, heartburn and diarrhea.

CONCLUSIONS

Gastric symptoms of PCS occur in one third of pts after elective cholecystectomies. Complete PCS develops after 3 months postoperatively what is likely connected with the change of diet. Excessive amount of intestinal gases, bloating, abdominal pain and diarrhea were the most common symptoms. The most intense complaint is persistent abdominal pain likely indicating comorbidities.

摘要

未标注

胆囊切除术后综合征(PCS)是胆囊切除术后可能出现并持续存在的一组胃肠道症状。PCS通常包括:腹痛或绞痛、消化不良、便秘或腹泻、恶心、腹胀、不耐受油腻食物。将PCS视为一种疾病实体仍存在诸多争议。

研究目的

评估罗兹医科大学普通外科和结直肠外科进行胆囊切除术后患者中PCS的患病率。材料与方法。在因症状性胆囊炎接受手术的243例患者队列中,对150例患者进行了调查。我们纳入了86例回答问卷的患者。使用改良的胃肠道症状评定量表(GSRS)测量PCS的患病率和症状强度——仅选择了6种通常与胆道系统病变相关的症状(腹痛、反跳痛、便秘、急迫性腹泻、恶心、腹胀)。

结果

胆囊切除术后,32例患者(37.2%)出现胃部不适。在12例患者(13.9%)中,症状强度相同。然而,在20例患者(23.25%)中,症状要么更严重,要么表现为全新的症状。与腹痛、烧心和腹泻不同,肠道气体过多(93.75%)和腹胀(87.5%)是最常见的症状。

结论

择期胆囊切除术后,三分之一的患者出现PCS的胃部症状。完全性PCS在术后3个月出现,这可能与饮食变化有关。肠道气体过多、腹胀、腹痛和腹泻是最常见的症状。最严重的主诉是持续性腹痛,这可能表明存在合并症。

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