A requiem for the cholecystokinin provocation test?
A requiem for the cholecystokinin provocation test?
复制标题
胆囊收缩素激发试验的安魂曲？
作者：
A. Smythe;A. Majeed;M. Fitzhenry;A. G. Johnson
背景-胆囊收缩素激发试验（CCKPT）被认为是预测非结石性胆源性疼痛患者胆囊切除术后更好的症状结果。目的：研究胆囊收缩素试验（CCKPT）阳性和阴性患者胆囊切除术后症状缓解的预测价值。患者和方法：58例非结石性胆源性疼痛患者接受CCKPT和连续超声胆囊容量测定。CCKPT阳性患者行胆囊切除术;阴性患者重新评估，如果症状持续，则行胆囊切除术。胆囊切除术后6个月，重复CCKPT。结果：32例CCK PT阳性患者中，27例行胆囊切除术，其中18例（67%）无胆囊炎。术后，25例患者中有20例转为CCKPT阴性，但5例仍为CCKPT阳性并有症状。在26例CCKPT阴性患者中，9例在未行胆囊切除术的情况下无症状; 14例接受胆囊切除术的患者中有6例（42.8%）无症状，且保持CCKPT阴性。胆囊切除术似乎可以减轻两组患者的症状，但术前CCKPT阳性和阴性患者的症状结局无显著差异。结论：在这项研究中，胆囊收缩素激发试验不能预测胆囊切除术的症状获益，我们建议它不应再用于评价非结石性胆源性疼痛患者。
Background—The cholecystokinin provocation test (CCKPT) has been claimed to predict a better symptomatic result after cholecystectomy in patients with acalculous biliary pain. Aims—To examine the predictive value of the CCKPT for symptom relief after cholecystectomy in both CCKPT positive and negative patients. Patients and methods—Fifty eight patients with acalculous biliary pain underwent CCKPT with serial ultrasound gall bladder volumetry. CCKPT positive patients were offered cholecystectomy; negative patients were reassessed and were offered a cholecystectomy if symptoms persisted. Six months after cholecystectomy, the CCKPT was repeated. Results—Of 32 CCKPT positive patients, 27 underwent cholecystectomy and of these, 18 (67%) became symptom-free. Postoperatively, 20 of 25 patients converted to CCKPT negative but five remained CCKPT positive and were symptomatic. Of the 26 CCKPT negative patients, nine became symptom-free without cholecystectomy; six of 14 (42.8%) patients undergoing cholecystectomy became asymptomatic and remained CCKPT negative. Cholecystectomy seemed to reduce symptoms in both groups, but there was no significant difference in the symptomatic outcome between preoperative CCKPT positive and negative patients. Conclusions—In this study, cholecystokinin provocation testing did not predict symptomatic benefit from cholecystectomy and we suggest it should no longer be used in the evaluation of patients with acalculous biliary pain.
胆囊收缩素胆囊造影、超声检查和闪烁扫描：慢性非结石性胆囊炎的检测。
DOI：
10.2214/ajr.139.6.1117
发表时间：
1982
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Davis,GB;Berk,RN;Scheible,FW;Witztum,KF;Gilmore,IT;Strong,RM;Hofmann,AF
通讯作者：
Hofmann,AF