Objective To discuss the pathogeny， treatment and prophylactic measures of postcholecystectomy syndrome (PCS). Methods The clinical data of 150 patients with laparoscopic PCS in our department from October 2000 to March 2009 were analyzed. Results Etiological factors were found in 131 patients: one hundred and twelve cases were due to the reasons of biliary system, including bile duct residual stones after cystic resection， the injury bile duct stenosis， a long residual cystic canal， nipple benign stricture, bile duct tumor etc; Nineteen examples were due to other reasons, including gallbladder stone merger reflux gastritis, gastroduodenal ulcer， diverticulum beside duodenal nipple, and so on, which resulted in the symptoms un-release after cystic resection. Nineteen cases were not found organic lesion. In ones whose etiological factors were definite, 117 cases were treated with different surgeries according to different etiological factors; another 33 cases were treated with conservative treatment. Total 145 cases were followed up, and 139 cases in them were cured or relieved at different degrees. Conclusion Careful preoperative examination, normalized operation avoiding damaging bile duct and leaving behind bile duct stones can effectively prevent laparoscopic PCS.
目的 探討胰性腦病的可能的發病機制、發病情況及防治措施.方法 計算機檢索中文科技期刊全文數據庫(1989～2004),收集有關胰性腦病的臨床研究,并進行統計分析.結果 共納入43篇文獻,435例患者.胰性腦病在重癥急性胰腺炎中的發病率遠高于輕癥急性胰腺炎;發病年齡趨向中、老年;病死率為43.67%;病因仍以膽系疾病為主;伴發低氧的幾率不高于未并發胰性腦病患者.結論 胰性腦病的發生可能是多因素共同作用的結果,仍需進一步探討其發病機制.血清髓鞘堿性蛋白有望成為有價值的診斷指標.防治以治療原發病急性胰腺炎為主,重在預防.胰酶抑制劑和早期營養支持有一定預防作用.