• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

老年高危手术患者胆囊切除术后胆囊收缩功能的危险因素

Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients.

作者信息

Wang Tao, Luo Hao, Yan Hong-Tao, Zhang Guo-Hu, Liu Wei-Hui, Tang Li-Jun

机构信息

General Surgery Center, Chengdu Military General Hospital, Chengdu, Sichuan, People's Republic of China.

出版信息

Clin Interv Aging. 2017 Jan 12;12:129-136. doi: 10.2147/CIA.S125139. eCollection 2017.

DOI:10.2147/CIA.S125139
PMID:28138229
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5238807/
Abstract

OBJECTIVE

Cholecystolithiasis is a common disease in the elderly patient. The routine therapy is open or laparoscopic cholecystectomy. In the previous study, we designed a minimally invasive cholecystolithotomy based on percutaneous cholecystostomy combined with a choledochoscope (PCCLC) under local anesthesia.

METHODS

To investigate the effect of PCCLC on the gallbladder contractility function, PCCLC and laparoscope combined with a choledochoscope were compared in this study.

RESULTS

The preoperational age and American Society of Anesthesiologists (ASA) scores, as well as postoperational lithotrity rate and common biliary duct stone rate in the PCCLC group, were significantly higher than the choledochoscope group. However, the pre- and postoperational gallbladder ejection fraction was not significantly different. Univariable and multivariable logistic regression analyses indicated that the preoperational thickness of gallbladder wall (odds ratio [OR]: 0.540; 95% confidence interval [CI]: 0.317-0.920; =0.023) and lithotrity (OR: 0.150; 95% CI: 0.023-0.965; =0.046) were risk factors for postoperational gallbladder ejection fraction. The area under receiver operating characteristics curve was 0.714 (=0.016; 95% CI: 0.553-0.854).

CONCLUSION

PCCLC strategy should be carried out cautiously. First, restricted by the diameter of the drainage tube, the PCCLC should be used only for small gallstones in high-risk surgical patients. Second, the usage of lithotrity should be strictly limited to avoid undermining the gallbladder contractility and increasing the risk of secondary common bile duct stones.

摘要

目的

胆囊结石是老年患者的常见疾病。常规治疗方法是开腹或腹腔镜胆囊切除术。在之前的研究中，我们设计了一种在局部麻醉下基于经皮胆囊造瘘术联合胆道镜的微创胆囊取石术（PCCLC）。

方法

为了研究PCCLC对胆囊收缩功能的影响，本研究对PCCLC与腹腔镜联合胆道镜进行了比较。

结果

PCCLC组的术前年龄和美国麻醉医师协会（ASA）评分，以及术后碎石率和胆总管结石率均显著高于胆道镜组。然而，术前和术后胆囊射血分数无显著差异。单因素和多因素逻辑回归分析表明，术前胆囊壁厚度（比值比[OR]：0.540；95%置信区间[CI]：0.317 - 0.920；P = 0.023）和碎石术（OR：0.150；95% CI：0.023 - 0.965；P = 0.046）是术后胆囊射血分数的危险因素。受试者工作特征曲线下面积为0.714（P = 0.016；95% CI：0.553 - 0.854）。

结论

应谨慎实施PCCLC策略。首先，受引流管直径限制，PCCLC仅适用于高危手术患者的小胆囊结石。其次，应严格限制碎石术的使用，以避免损害胆囊收缩功能并增加继发性胆总管结石的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/e4d9ed1a7b74/cia-12-129Fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/4370c12e9083/cia-12-129Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/751e70ed24fd/cia-12-129Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/b18d655c52f2/cia-12-129Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/bda1cbb2002c/cia-12-129Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/e4d9ed1a7b74/cia-12-129Fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/4370c12e9083/cia-12-129Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/751e70ed24fd/cia-12-129Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/b18d655c52f2/cia-12-129Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/bda1cbb2002c/cia-12-129Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c14f/5238807/e4d9ed1a7b74/cia-12-129Fig5.jpg

相似文献

1
Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients.老年高危手术患者胆囊切除术后胆囊收缩功能的危险因素
Clin Interv Aging. 2017 Jan 12;12:129-136. doi: 10.2147/CIA.S125139. eCollection 2017.
2
Ultrasound-guided double-tract percutaneous cholecystostomy combined with a choledochoscope for performing cholecystolithotomies in high-risk surgical patients.超声引导下双通道经皮胆囊造瘘术联合胆道镜在高危手术患者中进行胆囊取石术。
Surg Endosc. 2014 Jul;28(7):2236-42. doi: 10.1007/s00464-014-3451-8. Epub 2014 Feb 26.
3
Palliative percutaneous transhepatic gallbladder drainage of gallbladder empyema before laparoscopic cholecystectomy.在腹腔镜胆囊切除术之前对胆囊积脓进行姑息性经皮经肝胆囊引流术。
Hepatogastroenterology. 2000 Jul-Aug;47(34):932-6.
4
Combined surgical and radiologic intervention for complicated cholelithiasis in high-risk patients.高危患者复杂性胆石症的外科与放射学联合干预
Radiology. 1987 Dec;165(3):715-9. doi: 10.1148/radiology.165.3.3317502.
5
A new strategy of minimally invasive surgery for cholecystolithiasis: calculi removal and gallbladder preservation.一种微创治疗胆囊结石的新策略：取石保胆。
Dig Surg. 2013;30(4-6):466-71. doi: 10.1159/000357823. Epub 2014 Jan 30.
6
Gallstones in critically ill patients with acute calculous cholecystitis treated by percutaneous cholecystostomy: nonsurgical therapeutic options.经皮胆囊造瘘术治疗急性结石性胆囊炎危重症患者的胆结石：非手术治疗选择
AJR Am J Roentgenol. 1994 May;162(5):1101-3. doi: 10.2214/ajr.162.5.8165990.
7
Percutaneous cholecystolithotomy: a case for fulguration of the gallbladder wall.经皮胆囊取石术：胆囊壁电灼术的一个病例
J Laparoendosc Adv Surg Tech A. 2009 Jun;19(3):393-5. doi: 10.1089/lap.2008.0089.
8
Endoscopic ultrasound-assisted transmural cholecystoduodenostomy or cholecystogastrostomy as a bridge for per-oral cholecystoscopy therapy using double-flanged fully covered metal stent.内镜超声引导下经壁胆囊十二指肠吻合术或胆囊胃吻合术作为使用双凸缘全覆膜金属支架进行经口胆囊镜治疗的桥梁。
BMC Gastroenterol. 2016 Jan 19;16:9. doi: 10.1186/s12876-016-0420-9.
9
Percutaneous cholecystolithotomy: preliminary experience and technical considerations.经皮胆囊取石术：初步经验与技术要点
Radiology. 1989 Nov;173(2):487-91. doi: 10.1148/radiology.173.2.2798880.
10
[Percutaneous gallbladder drainage a good treatment in patients with acute cholecystitis and and poor clinical status].经皮胆囊引流术是急性胆囊炎且临床状况较差患者的一种良好治疗方法
Ned Tijdschr Geneeskd. 1993 Sep 25;137(39):1965-8.

引用本文的文献

1
Reconsideration of indications for choledochoscopic gallbladder-preserving surgery and preventive measures for postoperative recurrence of gallstones.关于胆道镜保胆手术适应证的重新审视及胆结石术后复发的预防措施
Wideochir Inne Tech Maloinwazyjne. 2020 Mar;15(1):87-96. doi: 10.5114/wiitm.2019.88647. Epub 2019 Oct 17.

本文引用的文献

1
Update on bedside ultrasound (US) diagnosis of acute cholecystitis (AC).床边超声（US）诊断急性胆囊炎（AC）的最新进展。
Intern Emerg Med. 2016 Mar;11(2):261-4. doi: 10.1007/s11739-015-1342-1. Epub 2015 Nov 4.
2
A proposal for a preoperative clinical scoring system for acute cholecystitis.急性胆囊炎术前临床评分系统的提案。
J Surg Res. 2016 Feb;200(2):473-9. doi: 10.1016/j.jss.2015.09.010. Epub 2015 Sep 9.
3
The Absence of Gallstones on Point-of-Care Ultrasound Rules Out Acute Cholecystitis.床旁超声检查未发现胆结石可排除急性胆囊炎。
J Emerg Med. 2015 Oct;49(4):475-80. doi: 10.1016/j.jemermed.2015.04.037. Epub 2015 Jul 7.
4
Differential diagnosis of gallbladder wall thickening: the usefulness of contrast-enhanced ultrasound.胆囊壁增厚的鉴别诊断：超声造影的应用价值
Ultrasound Med Biol. 2014 Dec;40(12):2794-804. doi: 10.1016/j.ultrasmedbio.2014.06.015.
5
Ultrasound-guided double-tract percutaneous cholecystostomy combined with a choledochoscope for performing cholecystolithotomies in high-risk surgical patients.超声引导下双通道经皮胆囊造瘘术联合胆道镜在高危手术患者中进行胆囊取石术。
Surg Endosc. 2014 Jul;28(7):2236-42. doi: 10.1007/s00464-014-3451-8. Epub 2014 Feb 26.
6
A new strategy of minimally invasive surgery for cholecystolithiasis: calculi removal and gallbladder preservation.一种微创治疗胆囊结石的新策略：取石保胆。
Dig Surg. 2013;30(4-6):466-71. doi: 10.1159/000357823. Epub 2014 Jan 30.
7
Predictive factors for the diagnosis of severe acute cholecystitis in an emergency setting.预测急诊中重症急性胆囊炎诊断的因素。
Surg Endosc. 2013 Sep;27(9):3388-95. doi: 10.1007/s00464-013-2921-8. Epub 2013 Apr 3.
8
Prevention of cholesterol gallstones by inhibiting hepatic biosynthesis and intestinal absorption of cholesterol.通过抑制肝脏合成和肠道吸收胆固醇预防胆固醇性胆囊结石。
Eur J Clin Invest. 2013 Apr;43(4):413-26. doi: 10.1111/eci.12058. Epub 2013 Feb 19.
9
The value of percutaneous ultrasound in predicting conversion from laparoscopic to open cholecystectomy due to acute cholecystitis.经皮超声在预测因急性胆囊炎行腹腔镜胆囊切除术转为开腹胆囊切除术的价值。
Surg Endosc. 2013 Jul;27(7):2561-8. doi: 10.1007/s00464-013-2787-9. Epub 2013 Feb 1.
10
Fluoroscopy-guided percutaneous gallstone removal using a 12-Fr sheath in high-risk surgical patients with acute cholecystitis.在患有急性胆囊炎的高危手术患者中，使用 12Fr 鞘进行透视引导下经皮胆囊结石取出术。
Korean J Radiol. 2011 Mar-Apr;12(2):210-5. doi: 10.3348/kjr.2011.12.2.210. Epub 2011 Mar 3.