AIM:To compare postcholecystectomy patients with Sphincter of Oddi(SO)dyskinesia and those with normal SO motility to determine the psychosocial distress,gender and objective clinical correlates of dyskinesia,and cont...AIM:To compare postcholecystectomy patients with Sphincter of Oddi(SO)dyskinesia and those with normal SO motility to determine the psychosocial distress,gender and objective clinical correlates of dyskinesia,and contrast these findings with comparisons between SO stenosis and normal SO motility.METHODS:Within a cohort of seventy-two consecutive postcholecystectomy patients with suspected SO dysfunction,manometric assessment identified subgroups with SO dyskinesia(n=33),SO stenosis(n=18)and normal SO motility(n=21).Each patient was categorized in terms of Milwaukee Type,sociodemographic status and the severity of stress-coping experiences.RESULTS:Logistic regression revealed that in combination certain psychological,sociodemographic and clinical variables significantly differentiated SO dyskinesia,but not SO stenosis,from normal SO function.Levels of psychosocial stress and of coping with this stress(i.e.anger suppressed more frequently and the use of significantly more psychological coping strategies)were highest among patients with SO dyskinesia,especially women.Higher levels of neuroticism(the tendency to stressproneness)further increased the likelihood of SO dyskinesia.CONCLUSION:A motility disturbance related to psychosocial distress may help to explain the finding of SO dyskinesia in some postcholecystectomy patients.展开更多
胆道系统的正常生理功能是承纳和传输肝脏持续分泌的胆汁,调控胆汁从肝向十二指肠的排放。胆道动力障碍性疾病主要包括胆囊和胆囊管运动功能障碍(gallbladder dyskinesia,GD)及胆管Oddi括约肌运动功能障碍(sphincter of Oddi dysfunctio...胆道系统的正常生理功能是承纳和传输肝脏持续分泌的胆汁,调控胆汁从肝向十二指肠的排放。胆道动力障碍性疾病主要包括胆囊和胆囊管运动功能障碍(gallbladder dyskinesia,GD)及胆管Oddi括约肌运动功能障碍(sphincter of Oddi dysfunction,SOD)等。临床上主要表现为反复发作的胆绞痛症状,严重影响患者的生活质量。随着各种检查技术及测压技术的应用和不断改进,我们对胆道系统运动及其功能障碍有了新的认识。排除器质性病变是诊断胆道动力障碍性疾病的关键,胆囊切除术是目前GD主要的治疗方法,Oddi括约肌压力测定及括约肌切开则在胆管SOD治疗中具有举足轻重的意义,但哪些患者更可能从上述治疗中获益,目前尚存争议,仍需要进一步研究探讨。展开更多
目的通过内镜下测定 Oddi 括约肌压力研究腹腔镜胆囊切除术(LC)后胆道运动功能,证明腹腔镜胆囊切除术后腹痛、上腹部不适可能与胆道动力障碍有关。同时证明胃泌素的升高与此相关。方法选择腹腔镜胆囊切除术后腹痛组20例,腹腔镜胆囊切除...目的通过内镜下测定 Oddi 括约肌压力研究腹腔镜胆囊切除术(LC)后胆道运动功能,证明腹腔镜胆囊切除术后腹痛、上腹部不适可能与胆道动力障碍有关。同时证明胃泌素的升高与此相关。方法选择腹腔镜胆囊切除术后腹痛组20例,腹腔镜胆囊切除术后上腹部不适组18例;对照组15例进行 B 超及 ERCP 测压。结果第一组病人基础压、波幅及波宽均升高。第二组基础压、波幅及波宽轻度升高。第三组正常。结论胆囊切除术后胆道动力障碍与 Oddi 括约肌痉挛,胆管壁顺应性,胃泌素分泌增多有关。展开更多
文摘AIM:To compare postcholecystectomy patients with Sphincter of Oddi(SO)dyskinesia and those with normal SO motility to determine the psychosocial distress,gender and objective clinical correlates of dyskinesia,and contrast these findings with comparisons between SO stenosis and normal SO motility.METHODS:Within a cohort of seventy-two consecutive postcholecystectomy patients with suspected SO dysfunction,manometric assessment identified subgroups with SO dyskinesia(n=33),SO stenosis(n=18)and normal SO motility(n=21).Each patient was categorized in terms of Milwaukee Type,sociodemographic status and the severity of stress-coping experiences.RESULTS:Logistic regression revealed that in combination certain psychological,sociodemographic and clinical variables significantly differentiated SO dyskinesia,but not SO stenosis,from normal SO function.Levels of psychosocial stress and of coping with this stress(i.e.anger suppressed more frequently and the use of significantly more psychological coping strategies)were highest among patients with SO dyskinesia,especially women.Higher levels of neuroticism(the tendency to stressproneness)further increased the likelihood of SO dyskinesia.CONCLUSION:A motility disturbance related to psychosocial distress may help to explain the finding of SO dyskinesia in some postcholecystectomy patients.
文摘胆道系统的正常生理功能是承纳和传输肝脏持续分泌的胆汁,调控胆汁从肝向十二指肠的排放。胆道动力障碍性疾病主要包括胆囊和胆囊管运动功能障碍(gallbladder dyskinesia,GD)及胆管Oddi括约肌运动功能障碍(sphincter of Oddi dysfunction,SOD)等。临床上主要表现为反复发作的胆绞痛症状,严重影响患者的生活质量。随着各种检查技术及测压技术的应用和不断改进,我们对胆道系统运动及其功能障碍有了新的认识。排除器质性病变是诊断胆道动力障碍性疾病的关键,胆囊切除术是目前GD主要的治疗方法,Oddi括约肌压力测定及括约肌切开则在胆管SOD治疗中具有举足轻重的意义,但哪些患者更可能从上述治疗中获益,目前尚存争议,仍需要进一步研究探讨。
文摘目的通过内镜下测定 Oddi 括约肌压力研究腹腔镜胆囊切除术(LC)后胆道运动功能,证明腹腔镜胆囊切除术后腹痛、上腹部不适可能与胆道动力障碍有关。同时证明胃泌素的升高与此相关。方法选择腹腔镜胆囊切除术后腹痛组20例,腹腔镜胆囊切除术后上腹部不适组18例;对照组15例进行 B 超及 ERCP 测压。结果第一组病人基础压、波幅及波宽均升高。第二组基础压、波幅及波宽轻度升高。第三组正常。结论胆囊切除术后胆道动力障碍与 Oddi 括约肌痉挛,胆管壁顺应性,胃泌素分泌增多有关。
