Wedmann B, Sonnleitner E, Kemen M, Kalthoff L, Schmidt-Heinevetter G, Wegener M
Medizinische Universitätsklinik, St.-Josef-Hospital Bochum.
Dtsch Med Wochenschr. 1991 Nov 8;116(45):1697-701. doi: 10.1055/s-2008-1063806.
Decrease in gall-bladder volume after intake of a test meal was assessed by ultrasound in 30 patients (24 females, 6 males; mean age 55 [22-82] years) with indications for elective or early elective cholecystectomy for cholelithiasis. Patients were assigned to three groups, based on intraoperative and histological gall-bladder changes: group 1 (n = 17), without changes or with mild chronic cholecystitis; group 2 (n = 4), with severe chronic inflammatory changes; group 3 (n = 9), with acute cholecystitis or cystic duct occlusion. A volume decrease of at least 30% after the test meal excluded only acute wall inflammation (negative predictive value 95.5%), while a volume reduction of at least 50% made it possible in a high percentage of cases (negative predictive value 88.2%) to predict correctly an absence of severe chronic wall changes. Before organ-preserving treatment (extracorporeal lithotripsy or local litholysis) is undertaken, gall-bladder volume reduction of at least 50% should be documented.
通过超声评估了30例因胆结石需择期或早期择期行胆囊切除术的患者（24例女性，6例男性；平均年龄55 [22 - 82]岁）在进食试验餐后胆囊体积的减小情况。根据术中及组织学上胆囊的变化，将患者分为三组：第1组（n = 17），无变化或有轻度慢性胆囊炎；第2组（n = 4），有严重慢性炎症变化；第3组（n = 9），有急性胆囊炎或胆囊管阻塞。试验餐后胆囊体积至少减小30%仅可排除急性壁炎症（阴性预测值95.5%），而至少减小50%则在高比例病例中（阴性预测值88.2%）能够正确预测无严重慢性壁变化。在进行保留器官治疗（体外震波碎石术或局部溶石术）之前，应记录胆囊体积至少减小50%的情况。
