99mTc-HIDA扫描在评估腹腔镜胆囊切除术患者胆囊运动障碍中的作用以及胆囊运动障碍与各种参数的比较。

IF 1.3 Q3 SURGERY
Minimally Invasive Surgery Pub Date : 2019-02-14 eCollection Date: 2019-01-01 DOI:10.1155/2019/5705039
Manuneethimaran Thiyagarajan, Eniyan Kamaraj, Nitesh Navrathan, Mohanapriya Thyagarajan, Balaji Singh Krishna
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引用次数: 0

摘要

目的:胆囊结石的发病机制包括胆囊肌肉收缩缺陷引起的胆汁淤积。本研究的目的是了解99mTc-HIDA扫描在评估胆囊结石患者腹腔镜胆囊切除术前胆囊运动障碍中的作用,并将胆囊运动障碍与患者症状、患者糖尿病状况、胆囊结石大小和数量以及术后组织病理学报告中的胆囊炎特征等各种参数进行比较。材料和方法:这是一项在我院进行的为期三年的前瞻性观察性研究。对40例胆囊结石患者进行99mTc-HIDA扫描,测定胆囊射血分数。对于所有这些患者,详细的临床病史、糖尿病等共病的存在和症状都得到了提示。对所有患者进行腹部超声检查,以评估结石的数量和大小。将所有参数制成表格并进行关联。结果:99mTc-HIDA扫描结果与患者症状比较,21.2%的患者无症状,78.8%的患者有症状,射血分数低于80%。EF>80%组的所有患者仅出现症状。这在统计学上并不显著。将99mTc-HIDA扫描结果与患者的糖尿病状态进行比较,42.4%的糖尿病患者和57.6%的非糖尿病患者的射血分数低于80%。99mTc-HIDA扫描结果与超声检查胆囊结石大小比较,大小小于1cm的63.6%和大于1cm的36.4%的患者射血分数<80%。有统计学意义(0.048)。将99mTc-HIDA扫描结果与超声检查中的结石数量进行比较,18.2%的单结石患者和81.8%的多发性结石患者EF小于80%,具有统计学意义(0.001)。将腹腔镜胆囊切除术后的99mTc-HDA扫描结果与组织病理学报告进行比较,21.2%的非胆囊炎患者和78.8%的胆囊炎患者EF小于80%,具有统计学意义(0.017)。结论:99mTc-HIDA扫描是诊断胆囊运动障碍的准确方法。99mTc-HIDA扫描胆囊运动障碍可用于术前预测大结石和多发结石。99mTc-HIDA扫描可提高诊断胆囊炎的灵敏度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of 99mTc-HIDA Scan for Assessment of Gallbladder Dyskinesia and Comparison of Gallbladder Dyskinesia with Various Parameters in Laparoscopic Cholecystectomy Patients.

Objectives: Pathogenesis of gallstone includes bile stasis due to defect in the gallbladder muscle contraction. Our aim of the study is to find out the role of 99mTc-HIDA scan in assessment of gallbladder dyskinesia in cholelithiasis patients before laparoscopic cholecystectomy and compare the gallbladder dyskinesia with various parameters like symptoms of patients, diabetic status of patients, gallstones size and number, and cholecystitis features in histopathology report after surgery.

Material and method: This is a prospective observational study conducted at our hospital for three years. Totally 40 patients with gallstone were subjected to 99mTc-HIDA scan, to assess the ejection fraction of gallbladder. For all these patients detailed clinical history, presence of comorbid illness like diabetics, and symptomatology were elicited. For all patients, ultrasonogram of abdomen was done to assess number and size of stones. All parameters were tabulated and correlated.

Result: While comparing 99mTc-HIDA scan findings with symptoms of patients, 21.2% were asymptomatic and 78.8% symptomatic patients who had ejection fraction less than 80%. All patients in EF >80% group were symptomatic only. It is not statistically significant. On comparing 99mTc-HIDA scan findings with diabetic status of the patients, 42.4% of diabetic and 57.6 % of nondiabetic patients had ejection fraction less than 80%. It is not statistically significant (0.681). While comparing 99mTc-HIDA scan findings with size of the gallstone in ultrasound, 63.6% patients with size less than 1cm and 36.4% with size more than 1cm had ejection fraction < 80%. It is statistically significant (0.048). On comparing 99mTc-HIDA scan findings with number of stones in ultrasound, 18.2% single gallstone patients and 81.8% multiple gallstone patients had EF less than 80% which is statistically significant (0.001). While comparing the 99mTc-HIDA scan findings with histopathology report after laparoscopic cholecystectomy, 21.2% non-cholecystitis patients and 78.8% cholecystitis patients had EF less than 80%, which is statistically (0.017) significant.

Conclusion: 99mTc-HIDA scan can be an accurate method to diagnose the gallbladder dyskinesia. Gallbladder dyskinesia in 99mTc-HIDA scan can be used to predict large size stones and multiple stones before surgery. The sensitivity can be improved by 99mTc-HIDA scan in diagnosing cholecystitis patients.

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