在没有完成胆囊切除术的情况下对Bouveret综合征进行手术治疗
Carrie Tackett1, Patrick Stahl1, Anthony McCloud1
1Community Memorial Hospital, 147 Brent St., Ventura, CA 9300, United States of America.
International journal of surgery case reports
|April 4, 2025
概括
布维雷特综合征是一种罕见的胆结石结核变体,可以通过单阶段手术来管理. 这种方法涉及无胆囊切除术的胆结石切除,有望在选择患者中降低发病率.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 消化系统疾病 消化系统疾病
背景情况:
- 布维雷特综合征是一种罕见的胆结石结核变体,其特征是由于胆结石通过胆肠进入肠道而导致胃出口阻塞.
- 它占机械肠道阻塞的不到0.1%,主要影响老年女性,并呈现出非特异性症状,导致诊断延迟和高死亡率 (12-30%).
- 传统的治疗涉及两阶段的手术方法:最初的石头去除,随后是间隔胆囊切除术和片修复,以防止复发.
研究的目的:
- 在年轻患者中呈现两例Bouveret综合征,使用单阶段手术方法管理.
- 评估在精选的Bouveret综合征病例中省略常规间隔胆囊切除术和状管修复的疗效和安全性.
- 讨论简化手术策略对布韦雷综合征管理的影响.
主要方法:
- 在年轻患者中对两个Bouveret综合征病例的回顾性审查.
- 手术管理涉及单个阶段的方法:切除胆结石,没有随后的胆囊切除术或片修复.
- 术后随访评估症状复发和长期结果.
主要成果:
- 两位年轻患者在单阶段手术后两年内都没有症状.
- 简化方法避免了与第二次手术相关的发病率.
- 研究结果表明,对于所有患有Bouveret综合征的年轻患者来说,常规间隔手术可能不需要.
结论:
- 选择性手术管理,省略常规间隔胆囊切除术和状管修复,可能是年轻的Bouveret综合征患者的可行选择.
- 这种方法有可能在不影响结果的情况下降低患者的发病率.
- 需要进行进一步的研究,以确定Bouveret综合征外科治疗的最终指导方针.
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