RESUMO
Own experience of surgical treatment of patients for postcholecystectomy syndrome (PCHES) in a 2010 - 2015 yrs period was enlighten. The PCHES modified classification was adduced, the immediate and remote results of the patients' treatment were analyzed, technical aspects and peculiarities of performance of some operative interventions, the risk factors for the PCHES occurrence were analyzed.
Assuntos
Ductos Biliares/cirurgia , Vesícula Biliar/cirurgia , Síndrome Pós-Colecistectomia/classificação , Síndrome Pós-Colecistectomia/diagnóstico , Algoritmos , Ductos Biliares/patologia , Ductos Biliares/fisiopatologia , Colecistectomia/métodos , Colecistectomia/reabilitação , Duodeno/patologia , Duodeno/fisiopatologia , Feminino , Vesícula Biliar/patologia , Vesícula Biliar/fisiopatologia , Humanos , Masculino , Pâncreas/patologia , Pâncreas/fisiopatologia , Síndrome Pós-Colecistectomia/fisiopatologia , Síndrome Pós-Colecistectomia/cirurgia , Estudos Retrospectivos , Fatores de RiscoRESUMO
AIM: To study the role of biliary acids (BAs) in the pathogenesis of chronic diarrhea (CD) in patients undergoing cholecystectomy (CE). SUBJECTS AND METHODS: Twenty-five patients with post-CE diarrhea were examined. A comparison group consisted of 11 patients with diarrhea-predominant irritable bowel syndrome (IBS). The results of an examination of 15 healthy individuals were taken as normal values. Daily fecal BAs were determined by an enzyme spectrophotometric technique. RESULTS: In the patients after CE, daily fecal BA losses were found to be thrice as large as that in the healthy individuals. In the comparison group of patients with IBS, fecal bile excretion was not greater than the normal values. Stool normalization with a simultaneous decrease in fecal BA losses was seen in 92% of the post-CE patients receiving a course of therapy with adsorbents and astringents. CONCLUSION: Post-CE CD is a type of postcholescystectomy syndrome.
Assuntos
Diarreia/diagnóstico , Fezes/química , Síndrome do Intestino Irritável/fisiopatologia , Síndrome Pós-Colecistectomia/diagnóstico , Adulto , Doença Crônica , Diarreia/etiologia , Diarreia/fisiopatologia , Feminino , Humanos , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/diagnóstico , Masculino , Síndrome Pós-Colecistectomia/classificação , Síndrome Pós-Colecistectomia/complicações , Espectrofotometria , Adulto JovemRESUMO
61 patients had a surgery because of postcholecystectomy syndrome (PCS). In 29 patients PCS was caused by bile tract diseases, in 15 patients--liver and pancreas diseases, in 12 cases disease of other organs. There was no mortality in restorative operations. The mortality rate in reconstructive operations was 5%. The full clinical and instrumental examination of extrahepatic bile ducts is the best way to prevent PCS. PCS was most frequently observed in patients, operated on urgently. The results of 79 cases of reconstructive and restorative operations in patients operated on urgently are analysed.
