Jazrawi S, Walsh T N, Byrne P J, Hennessy T P
University Department of Surgery, St. James's Hospital, Dublin.
Ir J Med Sci. 1993 Jun;162(6):209-12. doi: 10.1007/BF02945196.
Symptoms persist in a significant proportion of patients following cholecystectomy, some of which may have an oesophageal aetiology. The oesophagus has not previously been studied in this patient group. In this study all patients who had undergone cholecystectomy over a four year period were invited for review and symptoms were documented. Oesophageal function was examined and compared with normal controls. Patients were subdivided into symptomatic and asymptomatic subgroups and their findings compared. Symptoms were present in 53 percent of the postcholecystectomy group. The mean (sem) DeMeester acid score was higher in the post-cholecystectomy group -20.6 (3.6) than in controls -6.7 (0.9) (p = 0.01). The incidence of oesophagitis and gastritis were also increased in this group. There was a trend towards increased reflux and oesophagitis in the symptomatic compared with the asymptomatic subgroup. Other findings confined to the post-cholecystectomy group included nutcracker oesophagus in 4 and irritable bowel syndrome in 3. It is suggested that cholecystectomy may be associated with changes in oesophageal function which, in turn, may be associated with persistent symptoms.
相当一部分患者在胆囊切除术后症状仍会持续，其中一些可能由食管病因引起。此前尚未对该患者群体的食管进行研究。在本研究中，邀请了所有在四年期间接受过胆囊切除术的患者进行复查，并记录症状。检查食管功能并与正常对照组进行比较。将患者分为有症状和无症状亚组，并比较他们的检查结果。胆囊切除术后组中有53%的患者出现症状。胆囊切除术后组的平均（标准误）DeMeester酸评分-20.6（3.6）高于对照组-6.7（0.9）（p = 0.01）。该组食管炎和胃炎的发病率也有所增加。与无症状亚组相比，有症状亚组的反流和食管炎有增加的趋势。胆囊切除术后组的其他检查结果包括4例胡桃夹食管和3例肠易激综合征。提示胆囊切除术可能与食管功能改变有关，而这反过来又可能与持续症状有关。
