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-11 | DC14.1 |
| ICD-9-CM | 576.0 |
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或术后沾黏[4]。一项近期研究显示术后症候群可能肇因于胆道微结石[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。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[3]，此类患者可以使用胆酸结合剂进行治疗，如可林斯提拉明酯（cholestyramine）[3]、考来替泊（colestipol）[2]，或colesevelam[7]等药物都能够治疗且安全[8]。
症状
编辑相关症状包含[9]：
诊断
编辑- 腹部超声波
- 常规性血液检查及生化检验
- 静脉胆管造影术
- 胃十二指肠内视镜
- 经内视镜逆行性胆胰管摄影术（ERCP）
- 经内视镜逆行性胆胰管摄影术（ERCP）取得胆泥分析
- SeHCAT或其他与胆酸性腹泻相关检验
参考文献
编辑- ^ Postcholecystectomy syndrome. WebMD. [2009-03-07]. （原始内容存档于2007-07-02）.
- ^ 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）.
- ^ 3.0 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.
- ^ 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.
- ^ 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.
- ^ 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）.
- ^ 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.
- ^ 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.
- ^ nhs.uk, Complications of a gallbladder removal （页面存档备份，存于互联网档案馆）
- ^ 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.
