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| 題 名 | 內視鏡逆行性膽胰管攝影術在膽囊切除術後症候群病人的診斷及治療角色 |
|---|---|
| 作 者 | 謝財源; | 書刊名 | 醫學研究 |
| 卷 期 | 11:6 1991.05[民80.05] |
| 頁 次 | 頁453-459 |
| 分類號 | 416.247 |
| 關鍵詞 | 內視鏡逆行性膽胰管攝影術; 膽囊切除術後症候群; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 在45例膽囊切除術後症候群患者中,有41例(91.1%)成功地完成內視鏡逆行性膽胰管攝影術檢查。膽道系統發現異常者有35例(85.4%)。其中膽道性症狀組中,膽道系統異常比例為91.4%。而非膽道性症狀組則為50.0%,兩者有統計學上的差異(p<0.05)。雖然內視鏡逆行性膽胰管攝影術在膽道症狀組黃疸亞組中,膽道系統異常之比例高達100%,但膽道性症狀組非黃疸亞組,膽道系統異常比例亦有88.5%。膽道系統異常中仍以膽管結石為主,佔71.4%。而膽管結石的比例在膽道性症狀組中的非黃疸亞組及黃疸亞組並無統計學上的差異。膽道性症狀有二位總膽管結石患者接受內視鏡乳突括約肌切開術。二例均成功地取出結石。內視鏡逆行性膽胰管攝影術為目前診斷膽囊切除術後症候群病人之膽道系統異常的重要診斷工具,可檢視膽道系統手術前病灶的詳細位置,結石數目,並可鑑別診斷總膽管良性狹窄或惡性腫瘤。對於總膽管結石患者,尤其是年老體弱,不適於外科手術的病人,亦可行內視鏡乳突括約肌切開術取出結石,而提供另一種有效而可行的治療方式。 |
| 英文摘要 | Forty-five patients with postcholecystectomy syndrome received endoscopic retrograde cholangiopancreatography during a 4-year period. The procedure was successful in 41 patients (91.1%). ERCP detected abnormalities of biliary tract in 35 patients (85.4%). The abnormality rate was 91.4% in biliary group, and 50.0% in non-biliary group (P<0.05). Although all nine patients in biliary group with jaundice, who successfully received ERCP, showed abnormalities in the biliary tract, patients in biliary group without jaundice also presented with 88.5% abnormality rate. The biliary tract stones still represented the most common abnormality of ERCP in patients with postcholecystectomy syndrome and accounted for 71.4% of abnormaities. There was no statistical difference in the ratio of biliary tract stones between biliary group with jaundice and those without jaundice. Our two cases with common bile duct stones were treated successfully by endoscopic sphincterotomy. In conclusion, ERCP is a useful diagnostic tool in patients with postcholecystectomy syndrome. It may investigate the location of the lesion, the number of the biliary tract stone preoperatively; and distinguishes the benign stricture from the malignancy. Endoscopic sphincterotomy with stone removal has an important role in the treatment of retained or recurrent CBD stones, especially in aged, debilitated patients to whom the surgical intervention is not suitable. |
本系統中英文摘要資訊取自各篇刊載內容。