Gafá M, Sarli L, Miselli A, Pietra N, Carreras F, Peracchia A
Istituto di Clinica Chirurgica II, Parma University, Italy.
Surg Gynecol Obstet. 1987 Nov;165(5):413-8.
We have evaluated the incidence and evolution of sludge, microlithiasis and lithiasis formation of the biliary tract in 12 patients who underwent total gastrectomy and postoperative total parenteral nutrition (TPN) beginning immediately after operation. To this end, serial ultrasonographic studies are carried out every 72 hours during TPN and every seven days after oral refeeding and then once a month for three months. Sludge of the gallbladder was demonstrated in five of the 12 patients after a minimum period of nine days after the operation, and in four of these, microlithiasis of the biliary tract was subsequently revealed. In two of these four patients, the stones dissolved spontaneously, while in the remaining two patients, no change occurred in dimension after intervals of six and seven months, respectively. In all instances, sludge and microcalculi were completely "silent." This study was done to underline the high incidence of biliary tract sludge and microlithiasis in the patients examined and to indicate the necessity for preventive measures against the possible and serious complications of this disease as well as acute pancreatitis.
我们评估了12例接受全胃切除术并于术后立即开始全胃肠外营养（TPN）的患者胆道内淤胆、微结石及结石形成的发生率和演变情况。为此，在TPN期间每72小时进行一次系列超声检查，口服重新进食后每7天进行一次，然后连续三个月每月进行一次。12例患者中有5例在术后至少9天后出现胆囊淤胆，其中4例随后发现胆道微结石。这4例患者中有2例结石自行溶解，而其余2例患者分别在6个月和7个月后结石大小无变化。在所有情况下，淤胆和微结石均完全“无症状”。本研究旨在强调所检查患者中胆道淤胆和微结石的高发生率，并指出针对该疾病可能的严重并发症以及急性胰腺炎采取预防措施的必要性。
