Department of Surgery, Guthrie-Robert Packer Hospital, 1 Guthrie Sq, Sayre, 18840, PA, USA.
J Gastrointest Surg. 2012 Jan;16(1):135-40; discussion 140-1. doi: 10.1007/s11605-011-1742-0. Epub 2011 Nov 1.
Studies on biliary dyskinesia have been based on short-term surgical follow-up and do not take into consideration that most patients are discharged from surgical follow-up after the first postoperative visit and that for persistent or recurrent symptoms they are frequently seen by primary care providers and subsequently referred to gastroenterologists. We aimed to study this pattern and assess which factors predict patients that will benefit from cholecystectomy.
This is a retrospective analysis of medical records of patients who underwent cholecystectomy for biliary dyskinesia from February 2001 to January 2010 with a minimum postoperative follow-up of 6 months.
At initial surgical follow-up, 19 of 141 (13.4%) patients said they had persistent symptoms. However, when subsequent visits were analyzed, 61 of 141 (43.3%) patients with persistent or recurrent symptoms saw their primary care provider. These symptoms were epigastric or right upper quadrant pain in 43 patients or 30% of those undergoing cholecystectomy. The only factor that distinguished patients with and without resolution of symptoms after cholecystectomy was the pathologic finding of inflammation (p = 0.02).
Cholecystectomy does not appear to be as effective for biliary dyskinesia when long-term follow-up is evaluated.
关于胆运动障碍的研究一直基于短期的手术随访，并未考虑到大多数患者在首次术后随访后即已出院，并且对于持续性或复发性症状，他们通常由初级保健提供者进行治疗，随后再由胃肠病学家进行转介。我们旨在研究这种模式，并评估哪些因素可预测哪些患者将从胆囊切除术获益。
这是对 2001 年 2 月至 2010 年 1 月期间因胆运动障碍而行胆囊切除术的患者的病历进行的回顾性分析，所有患者的术后随访时间均至少为 6 个月。
在最初的手术随访中，141 例患者中有 19 例（13.4％）表示存在持续性症状。但是，当分析后续就诊时，141 例患者中有 61 例（43.3％）出现持续性或复发性症状，他们的初级保健提供者就诊。这些症状在 43 例患者中表现为上腹部或右上象限疼痛，占行胆囊切除术患者的 30％。在胆囊切除术后症状缓解和未缓解的患者之间唯一有区别的因素是炎症的病理发现（p=0.02）。
当进行长期随访时，胆囊切除术似乎对胆运动障碍的疗效并不理想。
