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[胆石溶解与胆囊憩室]

[Cholelitholysis and gallbladder diverticula].

作者信息

Wolpers C

出版信息

Rofo. 1984 Apr;140(4):397-407. doi: 10.1055/s-2008-1052996.

Abstract

Fifty patients with cholesterol stones in their gallbladder, with few symptoms were treated with the bile acids cheno- or ursodeoxycholic acid. 38 had a "normal" gallbladder, 12 had diverticula of the gallbladder. After the complete dissolution of the stones the bile acid treatment was stopped. The follow-up period lasted up to 7 years. No recurrence was observed in the gallbladder of 18 patients, but 32 developed new stones. With a second bile acid treatment we could dissolve the new stones of 13 patients, up to now without further relapses. After the second bile acid treatment of 9 months and x-ray controls 19 patients (38%) developed insoluble material in their gallbladders, independent of the presence of diverticula. We tried to eliminate calcium sediments with cholecystokinin-like substances. Temporary success was achieved in three of five patients only, and one person only remained free of further relapses. There is no reason to exclude patients with cholesterol stones and diverticula of the gallbladder from litholytic therapy.

摘要

50例胆囊胆固醇结石且症状轻微的患者接受了鹅去氧胆酸或熊去氧胆酸治疗。38例患者胆囊“正常”,12例有胆囊憩室。结石完全溶解后停止胆汁酸治疗。随访期长达7年。18例患者胆囊未见复发,但32例出现了新结石。再次使用胆汁酸治疗可溶解13例患者的新结石,目前未再复发。在进行9个月的第二次胆汁酸治疗及X线检查后,19例患者(38%)胆囊内出现了不溶性物质,这与是否存在憩室无关。我们尝试用胆囊收缩素样物质清除钙沉积物。仅5例患者中有3例取得了暂时成功,只有1例患者未再复发。没有理由将胆囊胆固醇结石合并胆囊憩室的患者排除在溶石治疗之外。

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