内镜括约肌切开术的胆道后遗症。
Biliary sequelae of endoscopic sphincterotomy.
作者信息
Greenfield C, Cleland P, Dick R, Masters S, Summerfield J A, Sherlock S
出版信息
Postgrad Med J. 1985 Mar;61(713):213-5. doi: 10.1136/pgmj.61.713.213.
Abstract
Twenty five patients were reviewed a mean of 36 months after successful endoscopic sphincterotomy for the removal of bile duct stones. All the patients had improved symptomatically but 20% had episodes of mild abdominal pain and a similar number had elevated serum gamma glutamyltranspeptidase activities (up to 3 times normal). In 12 patients (50%) biliary gas was demonstrated indicating reflux of duodenal contents. Clinical cholangitis did not occur. Aspiration liver biopsy revealed mild portal tract fibrosis and inflammation in patients with biliary reflux. Biliary reflux was significantly associated with mild upper abdominal pain (P less than 0.05). This study has shown that mild abnormalities of biliary function persist after endoscopic sphincterotomy. The long term consequence of these changes is unclear.
摘要
对25例因胆管结石成功接受内镜括约肌切开术的患者进行了平均36个月的随访。所有患者症状均有改善，但20%有轻度腹痛发作，且有相似比例的患者血清γ-谷氨酰转肽酶活性升高（最高达正常上限的3倍）。12例患者（50%）显示有胆道积气，提示十二指肠内容物反流。未发生临床胆管炎。抽吸式肝活检显示，存在胆汁反流的患者有轻度门静脉周围纤维化和炎症。胆汁反流与轻度上腹痛显著相关（P<0.05）。本研究表明，内镜括约肌切开术后胆汁功能仍存在轻度异常。这些改变的长期后果尚不清楚。
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