Einarsson K, Angelin B, Kelter U, Nyberg B, Sonnenfeld T
Acta Chir Scand Suppl. 1986;530:31-4.
Fifteen patients with history of biliary colic, induceable by cholecystokinin, but normal oral cholecystogram and ultrasonogram were studied prior to and after cholecystectomy. Fasting duodenal bile, obtained preoperatively after administration of cholecystokinin, and gallbladder bile obtained at operation were analyzed. The lipid composition as well as the cholesterol saturation were within the range seen in gallstone-free subjects. The total lipid concentration of gallbladder bile was normal, whereas that of duodenal bile was reduced by about 50%, indicating a less efficient gallbladder emptying. In 10 of the 15 patients, the analysis of the excised gallbladder displayed macro- or microscopic abnormalities; two patients had cholesterol gallstones. At re-examination 9-27 months after the operation, 12 of the patients were completely symptom-free and two patients reported a clear improvement while on still had unchanged symptoms. It is concluded that cholecystectomy is the treatment to prefer in patients with "acalculous" biliary pain, induceable by cholecystokinin.
对15例有胆绞痛病史、胆囊收缩素可诱发但口服胆囊造影和超声检查正常的患者，在胆囊切除术前和术后进行了研究。分析了术前注射胆囊收缩素后获得的空腹十二指肠胆汁以及手术中获得的胆囊胆汁。脂质组成以及胆固醇饱和度在无胆结石患者所见范围内。胆囊胆汁的总脂质浓度正常，而十二指肠胆汁的总脂质浓度降低了约50%，表明胆囊排空效率较低。15例患者中有10例切除胆囊的分析显示有宏观或微观异常；2例患者有胆固醇结石。术后9 - 27个月复查时，12例患者完全无症状，2例患者报告症状明显改善，1例患者症状无变化。结论是，胆囊切除术是治疗胆囊收缩素可诱发的“无结石”胆绞痛患者的首选治疗方法。
