Pihl Kerent D, Jones Mark W, Deppen Jeffery G, Ferguson Troy M, Hanses Suzanne M
McLaren Greater Lansing, Lansing, MI, USA.
Am J Surg. 2018 Jan;215(1):116-119. doi: 10.1016/j.amjsurg.2017.04.012. Epub 2017 Jun 19.
This is the largest single center retrospective study to date looking at response to laparoscopic cholecystectomy in patients with acalculous biliary disease. A chart review was completed on 1116 patients from 2009 to 2014 who had admitting diagnoses related to acalculous cholecystitis and biliary colic. Four hundred and seventy four patients were available for long term follow up (6 months or longer). Multiple factors were studied as related to cholescintigraphy scans with cholecystokinin administration (HIDA with CCK). Hyperkinetic, normokinetic and hypokinetic ejection fractions (EF), as well as reproduction of symptoms with administration of CCK were catagorized. ROME III criteria (Table 1) were used to describe cholecystitis/biliary colic symptoms. (1). It was found that rates of resolution of symptoms after laparoscopic cholecystectomy in normokinetic and hypokinetic were similar. It was also found that reproduction of symptoms after administration of CCK was a better predictor of favorable response to surgery than calculated ejection fraction.
这是迄今为止规模最大的一项单中心回顾性研究，旨在观察无结石性胆道疾病患者对腹腔镜胆囊切除术的反应。对2009年至2014年期间1116例诊断为无结石性胆囊炎和胆绞痛的患者进行了病历审查。474例患者可进行长期随访（6个月或更长时间）。研究了与注射胆囊收缩素的肝胆闪烁扫描（CCK激发的HIDA扫描）相关的多个因素。对高动力、正常动力和低动力射血分数（EF）以及注射CCK后症状的再现情况进行了分类。采用罗马III标准（表1）描述胆囊炎/胆绞痛症状。（1）发现正常动力和低动力患者腹腔镜胆囊切除术后症状缓解率相似。还发现，注射CCK后症状的再现比计算出的射血分数更能预测手术的良好反应。
