Recognition of Postcholecystectomy Syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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朱爱军 ¹ , 石景森 ²

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Keywords：

胆囊切除术后综合征; 病因; 诊断

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　　胆囊切除术(包括开腹胆囊切除术和腹腔镜胆囊切除术)是外科治疗胆囊良性疾病的标准术式，但是大约10%～30%的胆囊切除术患者会出现上腹或右上腹痛、餐后腹胀、消化不良、胆道感染或梗阻等临床症候群，发病时间从术后数周到数年，Pribram于1950年将上述症候群称为胆囊切除术后综合征(postcholecystectomy syndrome，PCS)，但何种原因导致上述症候群的出现未能明确［1］。随着影像学、内镜技术的发展，以及临床诊断技术的进步，特别是CT、MRI及磁共振胰胆管造影术(magnetic resonance cholangiopancreatography，MRCP)、内镜技术包括内镜超声(endoscopic ultrasound，EUS)和经内镜逆行性胰胆管造影术(endoscopic retrograde cholangiopancreatography，ERCP)的发展，绝大多数PCS患者能够明确病因并得到有效治疗。

Citation： 朱爱军,石景森. Recognition of Postcholecystectomy Syndrome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(4): 314-316. doi: Copy

1.	Schumpelick V, Truong S, Fass J, et al. Postcholecystectomy syndrome-still a current argument today? [J]. Langenbecks Arch Chir Suppl Ⅱ Verh Dtsch Ges Chir, 1990: 1205-1209.
2.	Tsoraides SS, Cha AI, Crawford DL. Postcholecystectomy biliary symptoms [J]. J Surg Educ, 2007; 64(4): 228-233.
3.	毕永林, 朱彤, 潘晓峰, 等. 胆囊切除术后综合征116例ERCP分析 [J]. 中华肝胆外科杂志, 2007; 13(1): 32-34.
4.	蔡忠方, 楼晓楼, 刘文勇. 内镜在胆囊切除术后综合征的病因诊治中的价值 [J]. 外科理论与实践, 2008； 13(2): 157-159.
5.	黄震, 王日武, 张为民, 等. 内镜在胆囊切除术后综合征病因诊断和治疗中的应用价值 [J]. 肝胆胰外科杂志, 2006; 18(4): 240-242.
6.	Duensing RA, Williams RA, Collins JC, et al. Managing choledocholithiasis in the laparoscopic era [J]. Am J Surg, 1995; 170(6): 619-623.
7.	Widdison AL, Longstaff AJ, Armstrong CP. Combined laparoscopic and endoscopic treatment of gallstones and bile duct stones: a prospective study [J]. Br J Surg, 1994; 81(4): 595-597.
8.	石景森. 胆道外科中不可忽视的问题 [J]. 肝胆胰外科杂志, 2005; 17(3): 178-179.
9.	吴硕东, 田雨, 苏洋, 等. 胆道疾病与十二指肠周围憩室关系的研究 [J]. 外科理论与实践, 2007; 12(4): 342-344.
10.	石景森, 朱爱军, 孙学军, 等. 胆囊切除术残留病变21例临床分析 [J]. 中国实用外科杂志, 2003; 23(2): 110-111.
11.	Gandolfi L, Torresan F, Solmi L, et al. The role of ultrasound in biliary and pancreatic diseases [J]. Eur J Ultrasound, 2003; 16(3): 141-159.
12.	Ney MV, Maluf-Filho F, Sakai P, et al. Echo-endoscopy versus endoscopic retrograde cholangiography for the diagnosis of choledocholithiasis: the influence of the size of the stone and diameter of the common bile duct [J]. Arq Gastroenterol, 2005; 42(4): 239-243.
13.	Buscarini E, Tansini P, Vallisa D, et al. EUS for suspected choledocholithiasis: do benefits outweigh costs? A prospective, controlled study [J]. Gastrointest Endosc, 2003; 57(4): 510-518.
14.	Tse F, Barkun JS, Romagnuolo J, et al. Nonoperative imaging techniques in suspected biliary tract obstruction [J]. HPB (Oxford), 2006; 8(6): 409-425.
15.	Filip M, Saftoiu A, Popescu C, et al. Postcholecystectomy syndrome-an algorithmic approach [J]. J Gastrointestin Liver Dis, 2009; 18(1): 67-71.
16.	Masci E, Toti G, Mariani A, et al. Complications of diagnostic and therapeutic ERCP: a prospective multicenter study [J]. Am J Gastroenterol, 2001; 96(2): 417-423.
17.	Barthet M, Lesavre N, Desjeux A, et al. Complications of endoscopic sphincterotomy: results from a single tertiary referral center [J]. Endoscopy, 2002; 34(12): 991-997.
18.	陈流华, 吴志棉, 郑朝旭, 等. 术前超声内镜检查预防腹腔镜胆囊切除术胆总管残余结石的临床价值 [J]. 中国实用外科杂志, 2009； 29(11): 928-930.

1. Schumpelick V, Truong S, Fass J, et al. Postcholecystectomy syndrome-still a current argument today? [J]. Langenbecks Arch Chir Suppl Ⅱ Verh Dtsch Ges Chir, 1990: 1205-1209.
2. 　Tsoraides SS, Cha AI, Crawford DL. Postcholecystectomy biliary symptoms [J]. J Surg Educ, 2007; 64(4): 228-233.
3. 　毕永林, 朱彤, 潘晓峰, 等. 胆囊切除术后综合征116例ERCP分析 [J]. 中华肝胆外科杂志, 2007; 13(1): 32-34.
4. 　蔡忠方, 楼晓楼, 刘文勇. 内镜在胆囊切除术后综合征的病因诊治中的价值 [J]. 外科理论与实践, 2008； 13(2): 157-159.
5. 　黄震, 王日武, 张为民, 等. 内镜在胆囊切除术后综合征病因诊断和治疗中的应用价值 [J]. 肝胆胰外科杂志, 2006; 18(4): 240-242.
6. 　Duensing RA, Williams RA, Collins JC, et al. Managing choledocholithiasis in the laparoscopic era [J]. Am J Surg, 1995; 170(6): 619-623.
7. 　Widdison AL, Longstaff AJ, Armstrong CP. Combined laparoscopic and endoscopic treatment of gallstones and bile duct stones: a prospective study [J]. Br J Surg, 1994; 81(4): 595-597.
8. 　石景森. 胆道外科中不可忽视的问题 [J]. 肝胆胰外科杂志, 2005; 17(3): 178-179.
9. 　吴硕东, 田雨, 苏洋, 等. 胆道疾病与十二指肠周围憩室关系的研究 [J]. 外科理论与实践, 2007; 12(4): 342-344.
10. 　石景森, 朱爱军, 孙学军, 等. 胆囊切除术残留病变21例临床分析 [J]. 中国实用外科杂志, 2003; 23(2): 110-111.
11. 　Gandolfi L, Torresan F, Solmi L, et al. The role of ultrasound in biliary and pancreatic diseases [J]. Eur J Ultrasound, 2003; 16(3): 141-159.
12. 　Ney MV, Maluf-Filho F, Sakai P, et al. Echo-endoscopy versus endoscopic retrograde cholangiography for the diagnosis of choledocholithiasis: the influence of the size of the stone and diameter of the common bile duct [J]. Arq Gastroenterol, 2005; 42(4): 239-243.
13. 　Buscarini E, Tansini P, Vallisa D, et al. EUS for suspected choledocholithiasis: do benefits outweigh costs? A prospective, controlled study [J]. Gastrointest Endosc, 2003; 57(4): 510-518.
14. 　Tse F, Barkun JS, Romagnuolo J, et al. Nonoperative imaging techniques in suspected biliary tract obstruction [J]. HPB (Oxford), 2006; 8(6): 409-425.
15. 　Filip M, Saftoiu A, Popescu C, et al. Postcholecystectomy syndrome-an algorithmic approach [J]. J Gastrointestin Liver Dis, 2009; 18(1): 67-71.
16. 　Masci E, Toti G, Mariani A, et al. Complications of diagnostic and therapeutic ERCP: a prospective multicenter study [J]. Am J Gastroenterol, 2001; 96(2): 417-423.
17. 　Barthet M, Lesavre N, Desjeux A, et al. Complications of endoscopic sphincterotomy: results from a single tertiary referral center [J]. Endoscopy, 2002; 34(12): 991-997.
18. 　陈流华, 吴志棉, 郑朝旭, 等. 术前超声内镜检查预防腹腔镜胆囊切除术胆总管残余结石的临床价值 [J]. 中国实用外科杂志, 2009； 29(11): 928-930.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Recognition of Postcholecystectomy Syndrome

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