Prediction of symptom improvement in children with biliary dyskinesia.
Prediction of symptom improvement in children with biliary dyskinesia.
复制标题
胆道运动障碍儿童症状改善的预测。
DOI：
10.1016/j.jss.2015.03.056
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Minneci,PeterC
中科院分区：
文献类型：
--
作者：
Mahida,JustinB;Sulkowski,JasonP;Cooper,JenniferN;King,AustinP;Deans,KatherineJ;King,DenisR;Minneci,PeterC
背景：胆囊切除术治疗胆道运动障碍的比率正在上升。我们的目的是确定临床症状改善的决定因素，在儿童接受胆囊切除术的胆道dyskinesia.MethodsThis回顾性队列研究包括胆囊切除术的胆道dyskinesia从2006-2013年谁有他们的胆囊射血分数（EF）测量胆囊收缩素刺激肝胆亚氨基二乙酸扫描和/或脂肪餐超声。在胆囊切除术后>1年对2010-2013年就诊的患者进行了访谈，以确定症状改善、症状完全消退以及与胆道运动障碍相关的任何术后临床干预。计算诊断试验对症状改善的敏感性和阳性预测值。多变量Logistic回归模型被用来确定术前特征与症状improvement.ResultsOf 153例患者，76%是女性，89%是白人，39%是肥胖。术后评估时，82%的患者报告症状改善，56%的患者症状完全缓解。对于肝胆亚氨基二乙酸和脂肪餐超声，测试预测症状改善的灵敏度随着EF的增加而增加，而阳性预测值保持在80%左右。在41名参与长期随访电话访谈的患者中，85%的患者报告症状改善，44%的患者报告症状完全缓解。与症状改善相关的因素包括较短的疼痛持续时间，呕吐的历史，和上腹部pain.ConclusionsDespite的历史没有确定EF水平预测症状改善，超过80%的患者接受胆囊切除术的胆道运动障碍报告症状改善。这些结果支持继续提供胆囊切除术治疗胆道运动障碍的儿童。
BackgroundRates of cholecystectomy for biliary dyskinesia are rising. Our objective was to identify clinical determinants of symptom improvement in children undergoing cholecystectomy for biliary dyskinesia.MethodsThis retrospective cohort study included patients undergoing cholecystectomy for biliary dyskinesia from 2006–2013 who had their gallbladder ejection fraction (EF) measured by either cholecystokinin-stimulated hepatobiliary iminodiacetic acid scan and/or fatty meal ultrasound. Patients presenting from 2010–2013 were interviewed >1 y after cholecystectomy to determine symptom improvement, complete symptom resolution, and any postoperative clinical interventions related to biliary dyskinesia. Sensitivity and positive predictive values for the diagnostic tests for symptom improvement were calculated. Multivariable logistic regression models were used to identify preoperative characteristics associated with symptom improvement.ResultsOf the 153 included patients, 76% were female, 89% were Caucasian, and 39% were obese. At postoperative evaluation, symptom improvement was reported by 82% of the patients and complete symptom resolution in 56%. For both the hepatobiliary iminodiacetic acid and fatty meal ultrasound, the sensitivity of the test to predict symptom improvement increased with higher EF, whereas the positive predictive values remained around 80%. Of the 41 patients who participated in phone interview for long-term follow-up, 85% reported symptom improvement and 44% reported complete symptom resolution. Factors associated with symptom improvement included a shorter duration of pain, a history of vomiting, and a history of epigastric pain.ConclusionsDespite not identifying an EF level that predicted symptom improvement, over 80% of patients undergoing cholecystectomy for biliary dyskinesia reported symptom improvement. These results support continuing to offer cholecystectomy to treat biliary dyskinesia in children.
登录
查看更多内容
胆道运动障碍的病理变化。
影响因子：
2.4
作者：
E. Brownie;R. Cusick;Deborah A Perry;S. Allbery;K. Azarow
通讯作者：
K. Azarow
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。
影响因子：
2.4
作者：
S. Michail;D. Preud’homme;Jeffery Christian;V. Nanagas;C. Goodwin;D. Hitch;A. Mezoff
通讯作者：
A. Mezoff
使用单剂量 99mTc 标记的肝胆剂连续测量胆囊排空。
影响因子：
29.4
作者：
G. Krishnamurthy;V. Bobba;E. Kingston;F. Turner
通讯作者：
F. Turner
腹腔镜胆囊切除术治疗儿童胆道运动障碍。
影响因子：
2.4
作者：
A. Kaye;Muralidhar Jatla;P. Mattei;J. Kelly;M. Nance
通讯作者：
M. Nance
儿童胆道运动障碍胆囊切除术后长期症状缓解的多机构分析
DOI：
--
发表时间：
2013
期刊：
Pediatric surgery international (Print)
影响因子：
--
作者：
E. Knott;F. Fike;A. Gasior;R. Cusick;E. Brownie;S. S. St. Peter;K. Azarow
通讯作者：
K. Azarow