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Am J Gastroenterol：生理盐水灌洗可显著降低结石手术后胆总管结石残留率

2018-04-03 zhangfan MedSci原创

胆结石生理盐水灌洗胆总管结石
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研究认为生理盐水灌洗可显著降低结石手术后胆总管结石残留率

在临床实践过程中，胆总管(CBD)结石残留可导致复发性胆管炎，即使在内镜取石后胆总管结石残留也时常发生。近日研究人员考察了内镜下胆总管结石手术后预防性生理盐水灌洗(PSIB)对减少胆总管结石残留的影响。

研究招募接受内镜逆行胰胆管造影术进行CBD结石手术的患者，随机接受PSIB或对照。研究的主要终点是术后6个月CBD结石残留。

148名患者参与研究并完成随访，其中PSIB组73人，对照组75人，组间基本信息相近。共22人(14.9%)存在CBD结石残留，而PSIB组结石残留率为6.8%，对照组为22.7%。多变量分析显示PSIB和仅一颗CBD结石是降低CBD结石残留率最显著因素。PSIB组患者手术时间延长(22.0 vs 19.2min， P=0.037)，但术后并发症组间无显著差异。

研究认为生理盐水灌洗可显著降低结石手术后胆总管结石残留率。

原始出处：


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    2018-08-06 zhouqu_8

    #AST#

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    2018-06-01 许安

    #GAS#

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    2018-08-16 jktdtl

    #Gastroenterol#

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time=2018-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302600, encodeId=dbb030260091, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Apr 04 07:35:25 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302402, encodeId=265c302402cf, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Tue Apr 03 18:05:08 CST 2018, time=2018-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302366, encodeId=b329302366a5, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Apr 03 12:20:01 CST 2018, time=2018-04-03, status=1, ipAttribution=)]
    2018-08-30 changfy

    #生理盐水#

    0

  5. 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time=2018-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302600, encodeId=dbb030260091, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Apr 04 07:35:25 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302402, encodeId=265c302402cf, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Tue Apr 03 18:05:08 CST 2018, time=2018-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302366, encodeId=b329302366a5, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Apr 03 12:20:01 CST 2018, time=2018-04-03, status=1, ipAttribution=)]
    2018-04-24 仁医小青年

    谢谢分享.学习了

    0

  6. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302366, encodeId=b329302366a5, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Apr 03 12:20:01 CST 2018, time=2018-04-03, status=1, ipAttribution=)]
    2018-11-15 zexyw01

    #生理盐水灌洗#

    0

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time=2018-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302600, encodeId=dbb030260091, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Apr 04 07:35:25 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302402, encodeId=265c302402cf, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Tue Apr 03 18:05:08 CST 2018, time=2018-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302366, encodeId=b329302366a5, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Apr 03 12:20:01 CST 2018, time=2018-04-03, status=1, ipAttribution=)]
    2018-04-05 yinhl1982

    #胆总管结石#

    0

  8. 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time=2018-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302600, encodeId=dbb030260091, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Apr 04 07:35:25 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302402, encodeId=265c302402cf, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Tue Apr 03 18:05:08 CST 2018, time=2018-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302366, encodeId=b329302366a5, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Apr 03 12:20:01 CST 2018, time=2018-04-03, status=1, ipAttribution=)]
    2018-04-04 明月清辉

    谢谢分享.学习了

    0

  9. 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time=2018-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302600, encodeId=dbb030260091, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Apr 04 07:35:25 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302402, encodeId=265c302402cf, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Tue Apr 03 18:05:08 CST 2018, time=2018-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302366, encodeId=b329302366a5, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Apr 03 12:20:01 CST 2018, time=2018-04-03, status=1, ipAttribution=)]
    2018-04-03 owlhealth

    不错耶.学习了

    0

  10. 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time=2018-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302600, encodeId=dbb030260091, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Apr 04 07:35:25 CST 2018, time=2018-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302402, encodeId=265c302402cf, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Tue Apr 03 18:05:08 CST 2018, time=2018-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302366, encodeId=b329302366a5, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Apr 03 12:20:01 CST 2018, time=2018-04-03, status=1, ipAttribution=)]
    2018-04-03 明月清辉

    谢谢分享.学习了

    0

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胆结石又称胆石症，是指胆道系统包括胆囊或胆管内发生结石的疾病。结石在胆囊内形成后，可刺激胆囊黏膜，引起胆囊的慢性炎症，当结石嵌顿在胆囊颈部或胆囊管后，还会引起继发感染，导致胆囊的急性炎症。而胆总管结石由于堵塞胆总管使胆汁排泄受阻引起的后果往往更加“凶险”。一造成胆结石的原因有哪些？胆结石大多由胆汁排泄不畅引起。任何影响胆固醇与胆汁酸浓度比例改变和造成胆汁淤滞的因素都能导致结石形成，具体原因包括：饮

哪几种胆囊必须切？

胆囊切除是普外科最常见的手术之一，当然，这离不开胆囊疾病的高发，胆囊疾病主要包括结石、息肉、癌等，但是并不是所有的胆囊疾病都需要切除胆囊，比如小编的某位领导已携胆囊结石息肉生存多年，大鱼大肉仍未见异常，这里，我们就来说说哪些胆囊是“要不得的”。

胆结石的预防和治疗

胆结石是胆囊内过饱和，卵石一样的胆汁。

为什么会得胆结石

近日秋风送爽，夏天正在悄悄离去，总结夏日的热门词汇，总少不了啤酒、烧烤、冰淇淋、减肥……在高频词汇的引导下，胆结石这一疾病也多了起来

Am J Pathol：胆结石不开刀：预防和治疗胆结石的新方法

根据目前的预估，美国将有2千万到2.5千万人会发展成胆结石，几乎是成年人口的15%。虽然只有一部分会出现胆结石的症状，但是每年接受胆结石手术的人也达到了70万。近期，发表于《美国病理学》杂志中的研究报道记录了预防和治疗胆结石的新方法，通过激活肝脏和小肠中的组织，从而减少胆汁输出。

Helicobacter：胆结石＆胆囊炎的又一危险因素，快来看看！

近年来，随着人们生活水平的提高，胆囊癌、胆管癌、胆结石、胆囊炎等的发病率逐渐升高。其中胆囊癌和胆管癌作为一种恶性肿瘤，严重威胁人类的健康。此外，胆结石作为一种常见病和多发病，在亚洲的发病率逐渐上升，从3.1％上升到10.7％。胆囊癌、胆管癌等胆囊恶性疾病目前病因尚不明确，可能与感染、胆结石等密切相关；