定义胆道高运动和胆囊切除术的作用
Akash Kartik1, Irving A Jorge2, Christopher Webb2
1From the Department of Surgery, Tulane University, New Orleans, LA (Kartik).
Journal of the American College of Surgeons
|June 27, 2023
概括
在胆囊扫描中,喷射分数 (EF) 截止值为81%可能表明胆道运动过度. 胆囊切除术推给有胆道症状,疼痛缓解EF高于81%的患者.
科学领域:
- 胃肠病学 胃肠病学
- 肝胆道手术 肝胆道手术
背景情况:
- 功能性胆囊乱通常通过胆囊结肠发作和胆囊低排泄分数 (EF) 在胆囊镜检查上进行诊断.
- 胆管高运动是一种功能性胆囊疾病,对胆囊切除术的定义和治疗作用不明确.
研究的目的:
- 确定最佳的射出分数 (EF) 截止值,以预测胆囊切除术后胆道动症患者的症状缓解.
- 建立胆道高运动症的诊断标准.
主要方法:
- 对接受胆固醇基因素刺激胆固醇切除术和胆固醇切除术 (2007-2020) 的患者的回顾性审查.
- 分析包括18岁以上的患者,有胆道症状,EF>50%,没有急性胆囊炎或胆病.
- 接收器操作特征曲线分析确定了预测症状解决的最佳EF截止值.
主要成果:
- 1596名患者EF≥50%,其中141名 (8.8%) 接受了胆囊切除术.
- 81%的EF截止值显著预测了胆囊切除术后的疼痛缓解 (78.2%对60.0%,p=0.03).
- 慢性胆囊炎在61.7%的最终病理学患者中被发现.
结论:
- 建议EF为81%作为正常胆囊EF的上限.
- 患有胆道症状和EF>81%且没有其他胆道疾病证据的患者可能患有胆道高运动症.
- 根据这些发现,建议对被诊断为胆道高运动的患者进行胆囊切除术.
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