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胆囊-肠瘘的诊断和处理进展。

Developments in the Diagnosis and Management of Cholecystoenteric Fistula.

机构信息

Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.

出版信息

J Invest Surg. 2022 Nov-Dec;35(11-12):1841-1846. doi: 10.1080/08941939.2022.2113188. Epub 2022 Sep 27.

Abstract

Cholecystoenteric fistula (CEF) is a rare complication of cholelithiasis. CEF refers to one or more pathological perforations between the gallbladder and the adjacent gastrointestinal tract, first described by Bartholin in 1645. The aim of this review is to examine the etiology, symptoms, diagnosis, and treatment of CEF. A literature search was conducted according to a set of criteria in PubMed for historical and current peer-reviewed studies regarding CEF. Clinical manifestations of CEF are always latent. Despite modern imaging studies and diagnostic methods, it is still very difficult to definitively diagnose CEF preoperatively. Instead, CEF is often accidentally discovered in the perioperative period or via intraoperative exploration. Without appropriate preoperative preparation, gastrointestinal injury and intraoperative bleeding often occur. CEF often goes unreported, and its diagnosis and treatment are still controversial. Early diagnosis of CEF is essential for effective treatment and improved outcome.

摘要

胆肠瘘(CEF)是胆石症的一种罕见并发症。CEF 是指胆囊和邻近胃肠道之间的一个或多个病理性穿孔,于 1645 年由 Bartholin 首次描述。本综述旨在探讨 CEF 的病因、症状、诊断和治疗。根据一组标准,在 PubMed 中对有关 CEF 的历史和当前同行评议研究进行了文献检索。CEF 的临床表现总是潜伏的。尽管有现代影像学研究和诊断方法,但术前明确诊断 CEF 仍然非常困难。相反,CEF 通常是在围手术期或通过术中探查偶然发现的。如果没有适当的术前准备,经常会发生胃肠道损伤和术中出血。CEF 常被漏诊,其诊断和治疗仍存在争议。早期诊断 CEF 对于有效治疗和改善预后至关重要。

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