Author/Editor		Skalicky, Marjan
Title		Ali holecistektomija vpliva na Oddijev sfinkter in ampulo papile Vateri?
Translated title		Does cholecystectomy affect the sphincter of Oddi and the ampulla of Vater?
Type		članek
Vol. and No.		Letnik 4, št. 1
Publication year		2011
Volume		str. 24-33
ISSN		1855-5640 - Acta medico-biotechnica : AMB
Language		eng
Abstract		Namen: 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 nevidljivosti.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-visibility.
Keywords		papila Vateri sfinkter Oddi holecistektomija endoskopski ultrazvok papilla of Vater sphincter of Oddi cholecystectomy endoscopic ultrasound