胆囊切除术后症候群

胆囊切除术后症候群(Postcholecystectomy syndrome)是描述在胆囊切除术英语cholecystectomy之后出现的一系列腹部症状。

胆囊切除术后症候群
分类和外部资源
医学专科胃肠学
ICD-11DC14.1
ICD-9-CM576.0
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大约5-40%的胆囊切除术患者会出现此类术后症候群[1],此类症状可能暂时出现,可能持续一阵子,也有一些人伴随终身[2][3]。有约10%的术后患者出现慢性症状。

术后症候群的腹痛症状可能来自于欧蒂氏括约肌功能不全英语sphincter of Oddi dysfunction术后沾黏[4]。一项近期研究显示术后症候群可能肇因于胆道微结石英语biliary microlithiasis[5]。约50%的病例是源自于胆道系统,例如残余结石、胆道损伤、胆道运动不良,以及胆道囊肿英语choledochal cyst。非胆道源性术后症候群则可能肇因于肠胃道功能性失调,例如消化不良[6]

慢性胆囊切除术后症候群属于一种胆酸性腹泻英语bile acid diarrhea[3],此类患者可以使用胆酸结合剂英语bile acid sequestrant进行治疗,如可林斯提拉明酯英语cholestyramine(cholestyramine)[3]考来替泊英语colestipol(colestipol)[2],或colesevelam英语colesevelam[7]等药物都能够治疗且安全[8]

症状

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相关症状包含[9]

诊断

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参考文献

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  1. ^ Postcholecystectomy syndrome. WebMD. [2009-03-07]. (原始内容存档于2007-07-02). 
  2. ^ 2.0 2.1 Danley T, St Anna L. Clinical inquiry. Postcholecystectomy diarrhea: what relieves it?. The Journal of Family Practice. October 2011, 60 (10): 632c–d [2019-04-11]. PMID 21977493. (原始内容存档于2019-12-13). 
  3. ^ 3.0 3.1 3.2 Sciarretta G, Furno A, Mazzoni M, Malaguti P. Post-cholecystectomy diarrhea: evidence of bile acid malabsorption assessed by SeHCAT test. The American Journal of Gastroenterology. December 1992, 87 (12): 1852–4. PMID 1449156. 
  4. ^ Hyvärinen H, Sipponen P, Silvennoinen E. Intestinal adhesions: an overlooked cause of the postcholecystectomy syndrome. Hepatogastroenterology. December 1990, 37 (Suppl 2): 58–61. PMID 2083937. 
  5. ^ Okoro N, Patel A, Goldstein M, Narahari N, Cai Q. Ursodeoxycholic acid treatment for patients with postcholecystectomy pain and bile microlithiasis. Gastrointestinal Endoscopy. July 2008, 68 (1): 69–74. PMID 18577477. doi:10.1016/j.gie.2007.09.046. 
  6. ^ Post-cholecystectomy symptoms were caused by persistence of a functional gastrointestinal disorder. [2019-04-11]. (原始内容存档于2019-12-17). 
  7. ^ Odunsi-Shiyanbade ST, Camilleri M, McKinzie S, et al. Effects of chenodeoxycholate and a bile acid sequestrant, colesevelam, on intestinal transit and bowel function. Clinical Gastroenterology and Hepatology. February 2010, 8 (2): 159–65. PMC 2822105 . PMID 19879973. doi:10.1016/j.cgh.2009.10.020. 
  8. ^ Mottacki N, Simrén M, Bajor A. Review article: bile acid diarrhoea - pathogenesis, diagnosis and management. Aliment. Pharmacol. Ther. 2016, 43: 884–898. PMID 26913381. doi:10.1111/apt.13570. 
  9. ^ nhs.uk, Complications of a gallbladder removal页面存档备份,存于互联网档案馆
  10. ^ Lamberts MP, Lugtenberg M, Rovers MM, Roukema AJ, Drenth JP, Westert GP, van Laarhoven CJ. Persistent and de novo symptoms after cholecystectomy: a systematic review of cholecystectomy effectiveness. Surg Endosc. 2013, 27 (3): 709–18. PMID 23052498. doi:10.1007/s00464-012-2516-9. 

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