Laparoscopic cholecystectomy: effective treatment for chronic abdominal pain in children with acalculous biliary pain.
Laparoscopic cholecystectomy: effective treatment for chronic abdominal pain in children with acalculous biliary pain.
复制标题
腹腔镜胆囊切除术：治疗非结石性胆道疼痛儿童慢性腹痛的有效方法。
DOI：
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发表时间：
2001
影响因子：
2.4
通讯作者：
A. Mezoff
中科院分区：
文献类型：
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作者：
S. Michail;D. Preud’homme;Jeffery Christian;V. Nanagas;C. Goodwin;D. Hitch;A. Mezoff
背景/目的
无结石胆道疼痛是一个术语，用于识别在没有胆石症的情况下因胆囊射血分数异常低而出现明显腹痛的患者。对于儿科人群中的这种疾病知之甚少。本研究的目的是确定腹腔镜胆囊切除术是否是治疗儿童腹痛的无结石胆道疼痛的有效方法，以及是否可以在术前预测结果。
方法
我们回顾了 1991 年 1 月至 1998 年 4 月期间在我们机构因无结石胆道疼痛而接受腹腔镜胆囊切除术的所有儿童的病历。 63 名患者被确定为患有无结石胆道疼痛的儿童，接受了腹腔镜胆囊切除术。成功联系到48名患者，并全部完成了问卷调查。 72% 的人腹痛完全缓解，另外 18% 的人疼痛几乎完全缓解。 8% 的人注意到有一些改善，只有 2% 的人没有改善。在多重逻辑模型中，没有一个变量是反应结果的显着预测因子。
结论
腹腔镜胆囊切除术是治疗小儿腹痛、胆囊射血分数低的有效手段。根据术前的临床表现很难预测患者是否完全缓解。
BACKGROUND/PURPOSE
Acalcular biliary pain is a term used to identify patients who have significant abdominal pain related to an abnormally low gallbladder ejection fraction in the absence of cholelithiasis. Little is known about this disease in the pediatric population. The aim of this study was to determine whether laparoscopic cholecystectomy is an effective method for treatment of children with abdominal pain in the setting of acalcular biliary pain and whether one can predict the outcome preoperatively.
METHODS
The charts of all children who underwent laparoscopic cholecystectomy for acalcular biliary pain in our institution from January 1991 through April 1998 were reviewed. Sixty-three patients were identified as children with acalcular biliary pain who underwent laparoscopic cholecystectomy. Forty-eight patients were contacted successfully and they all completed the questionnaire. Complete resolution of abdominal pain occurred in 72%, and another 18% had near-complete resolution of pain. Some improvement was noted by 8%, and only 2% had no improvement. In a multiple logistic model, none of the variables were significant predictors of response outcome.
CONCLUSIONS
Laparoscopic cholecystectomy is an effective means of therapy for children with abdominal pain and low gallbladder ejection fraction. It is difficult to predict patients with complete response based on the preoperative clinical findings.