Scheidegger A, Preisig R, Stirnemann H
Chirurg. 1980 Apr;51(4):213-8.
Of 739 cholecystectomies carried out from 1971 to 1978, 40 cases revealed intraoperatively a hydrops of the gallbladder. This hydrops was caused in all cases by a stone located in the gallbladder neck or the cystic duct. In 37 cases, the gallbladder contents were examined: clear "white bile" was present in 29 (78%); this was always very viscous. With one exception, all biles were found to be sterile. The pressure in the gallbladder averaged 61.5 cm saline, ranging from 15 to 115 cm. The osmolality of bile was on the average 295 mosmol/kg, thus being roughly isotonic with blood. In three cases, where chemical analysis of the bile was perfomed, bilirubin-, bile salts, cholesterol-, phospholipids, and protein-content were reduced to non-measurable amounts or to concentrations below 1 mg%. It is suggested that the mucosal inflammation following the obstruction to bile flow leads to disturbances in reabsorptive processes, secretion of mucous and a subsequent increase in intraluminal pressure.
在1971年至1978年期间实施的739例胆囊切除术中，有40例在手术中发现胆囊积水。所有这些病例中的胆囊积水均由位于胆囊颈部或胆囊管的结石引起。在37例病例中，对胆囊内容物进行了检查：29例（78%）存在清亮的“白胆汁”；其总是非常黏稠。除1例例外，所有胆汁均无菌。胆囊内压力平均为61.5厘米盐水柱，范围为15至115厘米。胆汁的渗透压平均为295毫摩尔/千克，因此与血液大致等渗。在3例对胆汁进行化学分析的病例中，胆红素、胆盐、胆固醇、磷脂和蛋白质含量降至无法测量的水平或浓度低于1毫克%。提示胆汁流动受阻后发生的黏膜炎症导致重吸收过程紊乱、黏液分泌以及随后管腔内压力升高。
