Lygidakis N J
Am J Gastroenterol. 1982 Jan;77(1):12-7.
Five hundred twenty-two patients who underwent choledochotomy because of biliary lithiasis are discussed herein to assess the relationship of different factors such as advanced age, previous surgery, length of clinical history, to the incidence of bile infection. It has been shown that bile infection is higher in patients of advanced age, previous surgery, and longstanding biliary lithiasis, and that it is also associated with a high incidence of common bile duct dilatation, a high incidence of common bile duct pathological changes, and a high incidence of common bile duct primary stones. From our findings in this study it is postulated that bile infection is a result of biliary stasis, and that for those patient poor drainage of the biliary tree due to dilatation and laxity of the bile duct is a predominant feature. The evidence for the above hypothesis after our barium meal studies seems clear, and thus a drainage procedure supplementary to choledochotomy appears to be warranted for those patients and is highly recommended from the results of this study.
本文讨论了522例因胆石症接受胆总管切开术的患者，以评估高龄、既往手术史、临床病史长短等不同因素与胆汁感染发生率之间的关系。结果表明，高龄、有既往手术史和长期胆石症患者的胆汁感染率较高，且胆汁感染还与胆总管扩张的高发生率、胆总管病理改变的高发生率以及胆总管原发性结石的高发生率相关。根据本研究的结果推测，胆汁感染是胆汁淤积的结果，对于这些患者而言，胆管扩张和松弛导致胆管引流不畅是一个主要特征。我们的钡餐研究结果似乎清楚地证明了上述假设，因此对于这些患者，在胆总管切开术的基础上进行引流手术似乎是必要的，并且根据本研究结果强烈推荐这样做。
