膽囊切除術後症候群

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膽囊切除術後症候群
醫學專科 胃肠学

膽囊切除術後症候群(Postcholecystectomy syndrome)是描述在膽囊切除術英语cholecystectomy之後出現的一系列腹部症狀。

大約5-40%的膽囊切除術患者會出現此類術後症候群[1],此類症狀可能暫時出現,可能持續一陣子,也有一些人伴隨終身[2][3]。有約10%的術後患者出現慢性症狀。

術後症候群的腹痛症狀可能來自於歐蒂氏括約肌功能不全英语sphincter of Oddi dysfunction術後沾黏[4]。一項近期研究顯示術後症候群可能肇因於膽道微結石英语biliary microlithiasis[5]。約50%的病例是源自於膽道系統,例如殘餘結石、膽道損傷、膽道運動不良,以及膽道囊腫英语choledochal cyst。非膽道源性術後症候群則可能肇因於腸胃道功能性失調,例如消化不良[6]

慢性膽囊切除術後症候群屬於一種膽酸性腹瀉英语bile acid diarrhea[3],此類患者可以使用膽酸結合劑英语bile acid sequestrant進行治療,如可林斯提拉明酯英语cholestyramine(cholestyramine)[3]考來替泊英语colestipol(colestipol)[2],或colesevelam英语colesevelam[7]等藥物都能夠治療且安全[8]

症狀[编辑]

相關症狀包含[9]

診斷[编辑]

參考文獻[编辑]

  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. PMID 21977493. [永久失效連結]
  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
  7. ^ Odunsi-Shiyanbade ST, Camilleri M, McKinzie S, 等. 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
  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. 

外部連結[编辑]

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