Tzardinoglou E, Prousalidis J, Apostolidis S, Katsohis C, Aletras H
Department of Medicine, Aristotles University of Thessaloniki, AHEPA Hospital, Greece.
HPB Surg. 1996;9(3):137-9. doi: 10.1155/1996/60802.
The removal of acalculous and not acutely inflamed gall-bladder in patients with typical biliary pain remains a questionable procedure. This study was conducted to present our experience. In the period 1982-90, 1089 cases of calculous and acalculous gallbladder disease were treated in our clinic. In this period, 27 patients were subjected to cholecystectomy because of an acalculous, non inflamed gallbladder which was elongated lying in an abnormal position with a long cystic duct. The mean duration of symptoms supportive of cholelithiasis, was 5 years. Oral cholecystogram and ultrasonography led to the diagnosis and other causes of chronic abdominal pain were excluded. There were 13 lumbar, 9 pelvic and 5 iliac gallbladders, with poor function in 20 of them. During cholecystectomy, the organ was invested by peritoneum and suspended in 7 cases from a mesentery. On pathological examination mild chronic inflammation was reported in 19 cases and minimal changes in 8. The minimum follow up was one year and the maximum 9 years. Complete relief of symptoms was achieved in all the cases. In conclusion, cholecystectomy should be offered in these symptomatic "hanging" gallbladders.
对于有典型胆绞痛症状的患者，切除无结石且无急性炎症的胆囊仍是一个存在争议的手术。本研究旨在介绍我们的经验。1982年至1990年期间，我院共治疗了1089例有结石和无结石的胆囊疾病患者。在此期间，有27例患者因胆囊无结石、无炎症，但胆囊拉长、位置异常且胆囊管较长而接受了胆囊切除术。支持胆石症的症状平均持续时间为5年。口服胆囊造影和超声检查确诊了病情，并排除了慢性腹痛的其他原因。其中有13例胆囊位于腰部，9例位于盆腔，5例位于髂部，20例胆囊功能不佳。在胆囊切除术中，7例胆囊被腹膜包裹并由肠系膜悬吊。病理检查显示，19例有轻度慢性炎症，8例有轻微改变。随访时间最短1年，最长9年。所有病例症状均完全缓解。总之，对于这些有症状的“悬吊”胆囊，应进行胆囊切除术。
