十二指肠乳头切开术治疗单纯胆囊切除术后原因不明的顽固性腹痛84例  

EST for the treatment of intractable abdominalgia in patients after simple cholecystectomy

作　　者：龚昭[1] 周新瑾[2] 周永碧[3] 

机构地区：[1]武汉市第一医院普外科 [2]中国人民解放军第四五七医院东湖分院 [3]中国人民解放军第三军医大学西南医院肝胆中心

出　　处：《中华普通外科杂志》2001年第6期338-339,共2页Chinese Journal of General Surgery

摘　　要：目的　探讨单纯胆囊切除术后原因不明的顽固性腹痛的病因 ,分析内窥镜下十二指肠乳头切开术 (endoscopicsphincterotomy ,EST)的治疗效果。方法　对 1987～ 1998年治疗的 84例患者进行追踪随访。界定单纯胆囊切除术后顽固性腹痛的概念 ,对这类患者采取EST治疗 ,术后留院观察2～ 3d。结果　随访率 77% (6 5 / 84) ,症状完全消失率 78% (5 1/ 6 5 ) ,偶有腹痛发作 9% (6 / 6 5 ) ,间断发作率 5 % (3/ 6 5 ) ,无效 8% (5 / 6 5 )。结论　EST在治疗单纯胆囊切除术后原因不明的顽固性腹痛方面效果显著。Objective To investigate the causes of intractable abdominalgia after simple choleystectomy and analyse the therapeutic effect of endoscopic sphincterotomy (EST).Methods 84 patients undergoing EST were retrospectively viewed from 1987 to 1998. Results Sixty five out of 84 patients were followed up, in which the clinical signs disappeared completely in 51 cases (78%), and there were 6 cases with relapsing symptom(9%),3 cases with intermittent relapsing symptom (4%). Therapy was ineffective in 5 cases. The intractable abdominalgia is a specific sign of postcholecystectomy syndrome. EST is effective in removing the nervous structure in duodenal papilla submucosa and sphincter muscle layer responsible for abdominal pain, therefore eliminated or relived the pain.Conclusion EST has a significant effect on intractable abdominalgia after simple cholecystectomy in the majority of patients.

关 键 词：括约肌切开术 内窥镜 胆囊切除术后综合征 腹痛 

分 类 号：R657.4[医药卫生—外科学]