肠内营养期间胆泥的形成：患病率及自然史。

Biliary sludge formation during enteral nutrition: prevalence and natural history.

作者信息

Schwesinger W H, Page C P, Strodel W E, Ghiatis A A, Chopra S, Gross G W, Sirinek K R

机构信息

Department of Surgery, University of Texas Health Science Center at San Antonio 78284-7842, USA.

出版信息

Surgery. 1998 Oct;124(4):768-71; discussion 771-2. doi: 10.1067/msy.1998.92011.

DOI:10.1067/msy.1998.92011

PMID:9781000

Abstract

BACKGROUND

Total parenteral nutrition is an etiologic factor in the formation of biliary sludge. We studied whether enteral nutrition is also a risk factor for sludge.

METHODS

Fifty patients with a needle catheter jejunostomy (NCJ) placed during a major abdominal operation underwent preoperative and weekly postoperative ultrasonography until NCJ feedings were discontinued (1 to 6 weeks).

RESULTS

All patients were men. The mean age was 63.2 +/- 1.6 years. Fourteen asymptomatic patients (28.0%) had biliary sludge within 2 weeks of beginning enteral feedings through a NCJ. Complete ultrasonographic resolution of sludge was observed in 13 of the 14 positive patients within 1 to 2 weeks of resuming an oral diet. One patient was lost to follow-up after 14 week; a positive sonogram had persisted but the patient remained asymptomatic. During the period of observation, no other patient had signs of biliary tract disease.

CONCLUSIONS

(1) Biliary sludge may form in some patients during enteral feeding with NCJ. (2) Sludge is cleared by the gallbladder once an oral diet is resumed. (3) There appears to be little risk of complications during postoperative enteral feeding.

摘要

背景

全胃肠外营养是胆泥形成的一个病因。我们研究了肠内营养是否也是胆泥形成的一个危险因素。

方法

50例在大型腹部手术期间放置了空肠穿刺导管（NCJ）的患者，在术前及术后每周接受超声检查，直至停止NCJ喂养（1至6周）。

结果

所有患者均为男性。平均年龄为63.2±1.6岁。14例无症状患者（28.0%）在通过NCJ开始肠内喂养后2周内出现胆泥。14例阳性患者中有13例在恢复口服饮食后1至2周内超声检查显示胆泥完全消失。1例患者在14周后失访；超声检查阳性结果持续存在，但患者仍无症状。在观察期间，没有其他患者出现胆道疾病的迹象。