Etiologies of Long-Term Postcholecystectomy Symptoms: A Systematic Review

Latenstein, Carmen S S; Wennmacker, Sarah Z.; Jong, Judith J de; Laarhoven, Cornelis J. H. M. van; Drenth, Joost P.H.; Reuver, Philip R. de

doi:10.1155/2019/4278373

Cited by 36 publications

(35 citation statements)

References 79 publications

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“…Таким образом, пациентам, перенесшим однократный эпизод необъяснимого острого панкреатита, проводить ЭРХПГ и манометрию СО не рекомендуется. Данное утверждение основано на том, что, как показала клиническая практика, второй эпизод может никогда не произойти или может быть отсроченным на много лет [2,4].…”

Section: транзиторное повышение активности алт аст ггтunclassified

“…Эксперты рекомендуют подходить к инвазивным процедурам во всех клинических ситуациях с большой осторожностью, учитывая краткосрочные и долгосрочные риски, а также ограниченные доказательства от их пользы. При этом большинство специалистов указывают на необходимость проведения развернутых клинических испытаний [3][4][5][6].…”

Section: лечениеunclassified

“…По данным разных источников, от 5 до 50% больных, перенесших холецистэктомию (ХЭ), продолжают предъявлять жалобы, аналогичные таковым до операции или изменившиеся по характеру и интенсивности [1][2][3][4][5]. Многим из них, особенно в России и в странах, входивших в состав СССР, автоматически устанавливается диагноз «постхолецистэктомический синдром» без детального анализа обусловливающих его причин.…”

Section: Introductionunclassified

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Sphincter of Oddi dysfunction in the post-cholecystectomy period

Буеверов

2020

Medicinskij sovet

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The persistent post-cholecystectomy (CE) symptoms can be divided into four groups: 1) surgical errors; 2) recurrence of cholelithiasis; 3) functional disorders due to removal of the gallbladder (transient or persistent); 4) pathology not associated with CE. Biliary pain persists in 20–40% of patients after CE, in most cases caused by sphincter of Oddi dysfunction (SOD). SOD is subdivided into biliary, pancreatic, two-duct types, as well as pancreatobiliary reflux. The SOD is rooted in the increased pressure in the sphincter, which leads to the increased intraductal pressure and, as a result, to the occurrence of biliary or pancreatic pain. In addition, the direct contractile effects of cholecystokinin on smooth muscles of the biliary tract change due to mechanical disturbance of innervation. Hypertension of the pancreatic part of the sphincter of Oddi can cause not only the occurrence of functional pain of the pancreatic type, but also the development of recurrent pancreatitis. SOD is characterized by typical anamnestic data that are common to the functional pathology of the digestive system, such as duration of symptoms, absence of organic pathology, multiple complaints, a non-progressive course, the provoking role of psychoemotional factors. From a practical standpoint, the clinical criteria for SOD can be: 1) an attack of biliary or pancreatic pain; 2) a transient increase in the activity of hepatic or pancreatic enzymes; 3) transient expansion of the common bile or major pancreatic duct. If it is difficult to differentiate diagnosis, endoscopic ultrasonography is advisable. Antispasmodics and ursodeoxycholic acid form the basis of the treatment, especially when biliary sludge and microlithiasis are detected. There must be strong arguments for the surgical treatment.

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Section: транзиторное повышение активности алт аст ггтunclassified

Section: лечениеunclassified

Section: Introductionunclassified

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Sphincter of Oddi dysfunction in the post-cholecystectomy period

Буеверов

2020

Medicinskij sovet

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“…Contrary to recent data, laparoscopic cholecystectomy (LC) has a lower morbidity and mortality rate as compared to the open technique [ 3 - 4 ]. The long-term sequelae of biliary spillage on LC range from mild inflammation to reactive fibrosis and abscess formation [ 5 - 6 ]. Thus, many advocate conversions to the open method when such a complication happens [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Dry Mopping vs. Saline Irrigation of Gallbladder Fossa After Bile Spillage During Laparoscopic Cholecystectomy: Randomized Control Trial

Bhatti¹,

Ahmad²

2021

Cureus

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Introduction The laparoscopic approach, as compared to open cholecystectomy, is still considered the gold standard, despite a higher incidence of micro insults. The most common approach to treat spilled biliary contents and lost stones in laparoscopic cholecystectomy is the retrieval of the stone through an open approach, or laparoscopically, ending with a peritoneal wash and aspiration. Material and methods We conducted a double-blinded randomized controlled trial. In the study group, patients with bile spillage during cholecystectomy underwent suction of all spilled bile and evacuation of all visible stones followed by dry mopping of the gallbladder fossa with gauze swab through an epigastric port. In the control group, after suction of all bile and visible stones, the gallbladder fossa was washed with 250 ml of saline, and fluid was aspirated through the epigastric port. Results Sixty patients were included (30 patients in each group), 71.6% were female and the rest were male. There was a statistically significant difference in pain scores between the two groups (p=0.001). The dry mopping group had lower pain scores as compared to the other group postoperatively. The incidence of the intraabdominal collection in both groups are statistically insignificant, however, port site infection and intraabdominal collection are higher in the control group (irrigation group). Conclusion Although there is not much literature on the best approach to biliary spillage in laparoscopic cholecystectomy. We believe that dry mopping had better postoperative patient outcome as compared to the saline wash.

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“…Although the majority of patients have pain relief following cholecystectomy, it is estimated that around 40% will continue to have pain postcholecystectomy,3 4 representing a significant number of individuals with morbidity. Postcholecystectomy pain (PCP) may be a persistence of the pain experienced precholecystectomy or a new pain.…”

Section: Introductionmentioning

confidence: 99%