胆囊切除术后综合征的诊治和预防

刘欢欢; 田雨; 彭洋; 于建发; 谢丰晓; 杨明威

doi:10.3969/j.issn.1001-5256.2018.11.043

胆囊切除术后综合征的诊治和预防

DOI: 10.3969/j.issn.1001-5256.2018.11.043

中国医科大学附属盛京医院第二普通外科

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中图分类号: R657.4
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出版历程
- 收稿日期: 2018-04-24
- 出版日期: 2018-11-20

Diagnosis, treatment, and prevention of postcholecystectomy syndrome

Second Department of General Surgery, Shengjing Hospital of China Medical University

摘要

摘要: 胆囊切除术后综合征（PCS）是腹腔镜胆囊切除术后较为常见且病因复杂的症候群,而非明确的疾病。然而PCS除与胆管结石和损伤、Oddi括约肌功能障碍等胆系因素有关外,术后胆汁酸池、法尼醇X受体和细胞表面受体BA-G蛋白偶联受体传导通路的异常、成纤维细胞生长因子19和表面活性蛋白D减少、体内胃动素、缩胆囊素等胃肠激素的改变以及与胆囊有关的各种生理反射、神经反射消失,这些生理功能的改变都可能是诱发PCS的因素。随着腹腔镜胆囊切除术数量的逐年增多,PCS的发病率也随之增高。将围绕PCS的病因、病理生理、诊断、治疗及预防进行简要归纳和总结。
- 胆囊切除术后综合征 /
- 胆囊切除术,腹腔镜 /
- 诊断 /
- 治疗学 /
- 综合预防 /
- 综述
Abstract: Postcholecystectomy syndrome ( PCS) is a common syndrome with complex etiologies after laparoscopic cholecystectomy, rather than a specific disease. In addition to bile duct stones, bile duct injury, and sphincter of Oddi dysfunction, PCS is also associated with the abnormalities in bile acid pool, farnesoid X receptor, and GPBAR1/TGR5 pathways after surgery, reductions in fibroblast growth factor 19 and surfactant protein D, changes in gastrointestinal hormones such as motilin and cholecystokinin, and disappearance of various physiological reflexes and nerve reflexes involving the gallbladder. All these changes in physiological function can induce PCS. As the number of patients undergoing laparoscopic cholecystectomy is increasing year by year, the incidence rate of PCS is also increasing. This article briefly summarizes the etiology, pathophysiology, diagnosis, treatment, and prevention of PCS.
- postcholecystectomy syndrome /
- cholecystectomy, laparoscopic /
- diagnosis /
- therapeutics /
- universal precautions /
- review

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