Eberle F, Rettenmaier G
Z Gastroenterol. 1984 Feb;22(2):82-7.
The appearance and the natural course of gallbladder sludge were studied by ultrasonography in 82 patients. Sludge was found in conditions with a functional or organic disturbance of gallbladder emptying: alcoholic cirrhosis and an atonic gallbladder in the fasting state, e.g., extrahepatic ductal obstruction and obstruction of the cystic duct. No clinical complaints could be attributed to sludge. After the normal bile flow had re-established the sludge disappeared in many cases. In 9 of 82 sludge-positive patients (10,9 per cent) ultrasonography revealed gallstone formation. Newly-formed stones obtained from 2 patients had the aspect of pigment stones and were analyzed by infrared spectroscopy. They consisted of calcium bilirubinate. This material constitutes the pigment granules which are suspended in the sludge. It was concluded that sludge was an early phase of stone formation. Alcoholic cirrhosis, obstruction of the biliary tract, gastrectomy, celiac sprue and prolonged fasting may predispose to lithiasis secondary to the precipitation of sludge in a large, atonic or distended gallbladder. Ultrasonography is instrumental to detect an early state of gallstone formation in those patients who carry a risk.
我们通过超声检查对82例患者胆囊内胆汁淤积物的表现及自然病程进行了研究。胆汁淤积物见于胆囊排空功能或器质性紊乱的情况：酒精性肝硬化以及空腹状态下胆囊张力缺乏，如肝外胆管梗阻和胆囊管梗阻。胆汁淤积物未引起任何临床症状。在胆汁正常流动恢复后，许多病例中的胆汁淤积物消失。82例胆汁淤积物阳性患者中有9例（10.9%）超声检查显示有胆结石形成。从2例患者获取的新形成结石外观呈色素结石，并进行了红外光谱分析。它们由胆红素钙组成。这种物质构成了悬浮在胆汁淤积物中的色素颗粒。由此得出结论，胆汁淤积物是结石形成的早期阶段。酒精性肝硬化、胆道梗阻、胃切除术、乳糜泻和长期禁食可能因胆汁淤积物在大的、张力缺乏或扩张的胆囊中沉淀而导致易患结石症。超声检查有助于在有风险的患者中检测胆结石形成的早期状态。
