胆总管内径与非结石、非肿瘤梗阻性胆囊切除术后综合征的关系

摘要

Objective To analyze the relationship between the inner diameter of common bile duct (CBD) and the morbility of postcholecystectomy syndrome (PCS) in non-tumor-and non-stone-associated obstruction. Methods Inner diameter of CBD was measured by color Doppler ultrasound in 300 patients with clinically diagnosed PCS (PCS group) and 306 patients without obvious postoperative symptoms (control group). The incidence of PCS was compared between patients undergoing open surgery and patients undergoing laparoscopic surgery. Results There were no significant differences in inner diameter of CBD between open surgery patients and laparoscopic surgery patients(P>0. 05). The incidence of PCS was high among patients with CBD diameter ≤6 mm,but low among patients with CBD diameter >6~≤12 mm(P<0. 01). No obvious differences was found between patients with CBD diameter >12 mm in PCS group and those in control(P>0. 05). Conclusion The incidence of non-obstructive PCS is not correlated with surgical procedures,but increases with the decrease of CBD diameter among post-cholecystectomy patients, especially among patients with CBD diameter >6~≤12 mm.%目的 探讨胆总管(CBD)内径与非结石、非肿瘤因素梗阻引起的胆囊切除术后综合征(PCS)的关系.方法 经彩超分别测量300例临床诊断为PCS患者(PCS组)的CBD内径,同时测量306例胆囊切除术后无明显症状患者(对照组)的CBD内径作为对照.并比较行开腹或腹腔镜手术者PCS的发病率.结果 开腹或腹腔镜手术者CBD的内径比较,差异无统计学意义(P＞0.05) ;CBD内径≤6 mm时,易出现PCS,CBD内径处于＞6～≤12 mm时PCS发病率较低(P＜0.01)；当CBD内径＞12 mm时,2组PCS的发病率差异无统计学意义(P＞0.05).结论 非梗阻性PCS的发病与手术方式无关,但是随着CBD内径的减小而增高,当CBD内径处于＞6～≤12 mm时发病率较低.