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老年患者胆总管直径:超声测量

Diameter of the common bile duct in the elderly patient: measurement by ultrasound.

作者信息

Kaim A, Steinke K, Frank M, Enriquez R, Kirsch E, Bongartz G, Steinbrich W

机构信息

Institute of Diagnostic Radiology, University Hospital Basel, Switzerland.

出版信息

Eur Radiol. 1998;8(8):1413-5. doi: 10.1007/s003300050563.

Abstract

We wanted to assess the width of the common bile duct (CBD) in an asymptomatic elderly (> 75 years) population, since no previous report has particularly considered the important age-related increase in CBD diameter for this patient group. CBD width of 92 asymptomatic people over 75 years of age (mean 84.7 years, range 75-96 years) without clinical or laboratory evidence for biliary, hepatocellular or pancreatic disease was measured by real-time high-resolution ultrasound of the upper abdomen. All examinations were performed by one experienced radiologist. Mean values were calculated for three groups: patients with and without cholecystolithiasis and after cholecystectomy. Statistical analysis was carried out by analysis of variance. Considering the measurements of all patients, the mean width (+/- SD) of the CBD was calculated as 6.5 +/- 2.5 mm. The difference between patients without cholecystolithiasis (6.2 +/- 2.3 mm) and patients after cholecystectomy (8.7 +/- 2.9 mm) was statistically significant (P < 0.0001). Cholecystolithiasis (6.0 +/- 1.6 mm) proves not to be an additional factor for CBD widening in comparison with patients without stone disease. The CBD of these very elderly subjects shows a considerable increase in comparison with the recommended borderline values in the ultrasound literature. An upper limit of 10 mm seems reasonable for patients with and without cholecystolithiasis. A significant increase in CBD width after cholecystectomy was found and measurements up to 14 mm may occur. Measurements have to be correlated with clinical and laboratory findings.

摘要

我们希望评估无症状老年(>75岁)人群中胆总管(CBD)的宽度,因为此前尚无报告特别考虑到该患者群体中与年龄相关的胆总管直径重要增加情况。通过上腹部实时高分辨率超声测量了92名75岁以上无症状患者(平均84.7岁,范围75 - 96岁)的CBD宽度,这些患者无胆道、肝细胞或胰腺疾病的临床或实验室证据。所有检查均由一名经验丰富的放射科医生进行。计算了三组的平均值:有和无胆囊结石的患者以及胆囊切除术后的患者。通过方差分析进行统计分析。考虑所有患者的测量值,CBD的平均宽度(±标准差)计算为6.5±2.5mm。无胆囊结石患者(6.2±2.3mm)与胆囊切除术后患者(8.7±2.9mm)之间的差异具有统计学意义(P < 0.0001)。与无结石疾病的患者相比,胆囊结石(6.0±1.6mm)并非导致CBD增宽的额外因素。与超声文献中推荐的临界值相比,这些高龄受试者的CBD宽度有显著增加。对于有和无胆囊结石的患者,10mm的上限似乎是合理的。发现胆囊切除术后CBD宽度显著增加,可能出现高达14mm的测量值。测量结果必须与临床和实验室检查结果相关联。

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