Rogos R, Schneider G, Mühlig K, Petros S
Medizinisch-Poliklinisches Institut, Universität Leipzig.
Z Gesamte Inn Med. 1991 Jul;46(9):315-7.
In patients with upper abdominal complaints after cholecystectomy the normal and disordered bile flow was evaluated using quantitative scintigraphy after initially excluding organic etiology. A continuous intravenous infusion of cholecystokinin and secretin for one hour resulted in an accelerated bile flow in the majority of these patients, which is the normal reaction of the biliary system under stimulation. On the contrary, a bolus injection of these hormones led to marked delay of flow in a group of the study population, a condition taken as a paradoxical reaction to cholecystokinin. Although all of the patients with this paradoxical reaction did complain of typical biliary pain, a causal association is, however, yet to be proved. Nitrates can be helpful in the differential diagnosis of impeded bile flow, a lack of response being a possible sign of organic hindrance at the papilla of Vater.
在胆囊切除术后出现上腹部不适的患者中，在初步排除器质性病因后，使用定量闪烁扫描评估正常和紊乱的胆汁流动情况。持续静脉输注胆囊收缩素和促胰液素一小时，导致这些患者中的大多数胆汁流动加速，这是胆道系统在刺激下的正常反应。相反，在一组研究人群中，一次性注射这些激素导致胆汁流动明显延迟，这种情况被视为对胆囊收缩素的矛盾反应。尽管所有出现这种矛盾反应的患者都确实诉说有典型的胆绞痛，但因果关系尚未得到证实。硝酸盐有助于胆汁流动受阻的鉴别诊断，无反应可能是 Vater 乳头器质性梗阻的迹象。
