Tulassay Z, Papp J, Kollin E, Koller O
Wien Klin Wochenschr. 1981 Jan 23;93(2):55-60.
542 patients were subjected to ERCP at various periods after cholecystectomy. In this selected patient material there was a 56% incidence of morphological abnormalities in the biliary system, stenosis of the papilla and choledocholithiasis being the most frequent pathological findings. Laboratory examinations proved to be irrelevant with respect to the morphology of the bile ducts. A direct relationship between the clinical symptoms and the surgical procedure was established only in cases presenting with biliary duct stenosis (11% of all cases examined). In the majority of patients the postcholecystectomy complaints were due to incorrect surgical indication or inadequate surgical technique. Postcholecystectomy syndrome can be prevented by more accurate evaluation of the patient prior to and during surgery.
542例患者在胆囊切除术后不同时期接受了内镜逆行胰胆管造影(ERCP)检查。在这个经过挑选的患者群体中,胆道系统形态异常的发生率为56%,乳头狭窄和胆总管结石是最常见的病理表现。实验室检查结果与胆管形态无关。仅在出现胆管狭窄的病例(占所有检查病例的11%)中,临床症状与手术操作之间建立了直接关系。在大多数患者中,胆囊切除术后的不适是由于手术指征判断错误或手术技术不熟练所致。通过在手术前和手术过程中对患者进行更准确的评估,可以预防胆囊切除术后综合征。