36 KB4650 KB26 KB200820252011Skalicky, Marjanštevilka:1letnik:4str. 24-33ISSN:1855-5640COBISSID:512121144URN:URN:NBN:SI:doc-1MA0D6CGenMedicinska fakultetaActa medico-biotechnicacholecystectomyendoscopic ultrasoundendoskopski ultrazvokholecistektomijapapila Vateripapilla of Vatersfinkter Oddisphincter of OddiAli holecistektomija vpliva na oddijev sfinkter in ampulo papile vateri?| Does cholecystectomy affect the sphincter of oddi and the ampulla of vater?|Purpose: About 20-50% of cholecystectomized patients complain of dyspeptic problems after gallstone surgery. I hypothesized that some of these problems do not arise from primary gallbladder disease, but are due to problems of duodenal origin. Methods: I examined 80 patients using endoscopic ultrasound (EUS) before gallstone surgery (AOP). I repeated the examination 3 months (POP3) and 6 months (POP6) after the surgery. Fifty patients who underwent surgery were symptomatic; 30 were asymptomatic. In all patients, an analysis of the papilla of Vater (PV) was carried out with a special focus on the visibility of the sphincter of Oddi complex (SOC) and the ampulla of papilla (AP). Results: The visibility of the SOC was significant in the measurements AOP/POP3 (p<0.05). The comparison POP3/POP6 (p<0.001) was also significant. The behavior pattern of the AP (AOP/POP3, POP3/POP6, AOP/POP6) in various measurements was not significant (p>0.05). The linear percentage increase of non-visible AP (76%, 78%, and 80%) indicated different changes in the mechanism with respect to visibility of the SOC; 52% (AOP), 72% (POP3) and 50% (POP6). Conclusions: These data showed that cholecystectomy affected the visibility of the SOC. The AP, with its embryological and histological disposition based on a duodenal pattern (SOC is based on a biliary pattern), showed non-significant linear trends of increased non-visibilityNamen: Ker ima 20-50 % holecistektomirancev tudi po operaciji žolčnih kamnov nadaljnje dispeptične težave, želim dokazati, da del teh težav ne izvira iz primarne bolezni žolčnika s kamni, ampak so drugega, natančneje duodenalnega izvora. Metode: Z endoskopskim ultrazvokom (EUZ) sem pred operacijo (AOP) žolčnih kamnov pregledal 80 bolnikov. Tri mesece po operaciji (POP3) in 6 mesecev po njej (POP6) sem preiskavo ponovil. 50 operirancev je bilo simptomatskih, 30 pooperativno asimptomatskih. Pri vseh sem opravil analizo papile Vateri (PV) s posebnim poudarkom na analizi vidljivosti sfinkterja Oddi kompleksa (SOK) in ampule papile (AP). Rezultati: Vidljivost SOK je signifikantna v meritvah AOP/POP3 (p < 0.05) iz prikazanih sprememb. Prav tako je signifikantna primerjava POP3/POP6 (p < 0.001). Vzorec obnašanja AP (AOP/ POP3, POP3/POP6, AOP/POP6) v različnih meritvah ni signifikanten (p > 0.05). Linearno zvečanje odstotka nevidnih AP (76 %, 78 %, 80 %) kaže na druge mehanizme sprememb, kot sem jih ugotovil pri vidljivosti SOK 52 % (AOP), 72 % (POP3) in 50 % (POP6). Zaključek: Holecistektomija očitno deluje incidentalno na vidljivost SOK. To potrjujejo klinične izkušnje v potrebnem rekonvalenscentnem dietetnem režimu nekaj mesecev po operaciji, ki so potrebne za reprogramiranje SOK-a . AP, ki se obnaša po svoji embrionalni in histološki zasnovi po duodenalnem vzorcu (SOK po biliarnem), pa kaže počasne nesignifikantne linearne trende zvišane nevidljivostiTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaUniverza v Mariboru, Medicinska fakulteta