腹腔镜时代的坏疽性胆囊炎。

D R Hunt, F C Chu
{"title":"腹腔镜时代的坏疽性胆囊炎。","authors":"D R Hunt,&nbsp;F C Chu","doi":"10.1046/j.1440-1622.2000.01851.x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We reviewed our data of laparoscopic cholecystectomies between 1990 and 1997 with reference to gangrenous cholecystitis.</p><p><strong>Methods: </strong>In a consecutive series of 1304 patients having laparoscopic cholecystectomies, prospective data collection has permitted analysis of the relationship between gangrenous cholecystitis (GC), acute (non-gangrenous) cholecystitis (AC) and non-acute cholecystectomies (NAC).</p><p><strong>Results: </strong>Twenty-five patients had gangrenous cholecystitis and 238 had acute cholecystitis. We found that patients with GC were significantly older (65.4 years vs 56.1 years (AC) and 52.7 years (NAC), P < 0.05) and had a higher M: F ratio (1.5:1 vs 1:2.6 (AC) and 1:2.8 (NAC), P < 0.05). Cardiac disease was found to be a significant factor but not diabetes. Preoperative ultrasonography correctly identified only 17 patients with acute inflammatory changes. Seven patients had an absent sonographic Murphy's sign. The gall bladder wall was generally thicker (4.11 mm vs 3.8 mm (AC) and 2.7 mm (NAC), P < 0.05) but there was marked overlap between the three groups. The common bile duct (CBD) was more dilated (6.1 mm vs 4.8 mm (AC) and 4.6 mm (NAC), P < 0.006) and there was increased incidence of CBD stones in the GC group. Our conversion rate was 8.7% with minimal complications and no operative mortality.</p><p><strong>Conclusion: </strong>Patients with GC were generally older, more likely to be male and had increased incidence of cardiovascular disease. Preoperative ultrasound cannot accurately identify those patients with gangrenous cholecystitis, but with conversion rates of 8.7% and no operative mortality, they can generally be managed safely with laparoscopic surgical techniques.</p>","PeriodicalId":22494,"journal":{"name":"The Australian and New Zealand journal of surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1440-1622.2000.01851.x","citationCount":"85","resultStr":"{\"title\":\"Gangrenous cholecystitis in the laparoscopic era.\",\"authors\":\"D R Hunt,&nbsp;F C Chu\",\"doi\":\"10.1046/j.1440-1622.2000.01851.x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We reviewed our data of laparoscopic cholecystectomies between 1990 and 1997 with reference to gangrenous cholecystitis.</p><p><strong>Methods: </strong>In a consecutive series of 1304 patients having laparoscopic cholecystectomies, prospective data collection has permitted analysis of the relationship between gangrenous cholecystitis (GC), acute (non-gangrenous) cholecystitis (AC) and non-acute cholecystectomies (NAC).</p><p><strong>Results: </strong>Twenty-five patients had gangrenous cholecystitis and 238 had acute cholecystitis. We found that patients with GC were significantly older (65.4 years vs 56.1 years (AC) and 52.7 years (NAC), P < 0.05) and had a higher M: F ratio (1.5:1 vs 1:2.6 (AC) and 1:2.8 (NAC), P < 0.05). Cardiac disease was found to be a significant factor but not diabetes. Preoperative ultrasonography correctly identified only 17 patients with acute inflammatory changes. Seven patients had an absent sonographic Murphy's sign. The gall bladder wall was generally thicker (4.11 mm vs 3.8 mm (AC) and 2.7 mm (NAC), P < 0.05) but there was marked overlap between the three groups. The common bile duct (CBD) was more dilated (6.1 mm vs 4.8 mm (AC) and 4.6 mm (NAC), P < 0.006) and there was increased incidence of CBD stones in the GC group. Our conversion rate was 8.7% with minimal complications and no operative mortality.</p><p><strong>Conclusion: </strong>Patients with GC were generally older, more likely to be male and had increased incidence of cardiovascular disease. Preoperative ultrasound cannot accurately identify those patients with gangrenous cholecystitis, but with conversion rates of 8.7% and no operative mortality, they can generally be managed safely with laparoscopic surgical techniques.</p>\",\"PeriodicalId\":22494,\"journal\":{\"name\":\"The Australian and New Zealand journal of surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2000-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1046/j.1440-1622.2000.01851.x\",\"citationCount\":\"85\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Australian and New Zealand journal of surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1046/j.1440-1622.2000.01851.x\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Australian and New Zealand journal of surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1046/j.1440-1622.2000.01851.x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 85

摘要

背景:我们回顾了1990年至1997年腹腔镜胆囊切除术中坏疽性胆囊炎的资料。方法:对1304例连续行腹腔镜胆囊切除术的患者进行前瞻性数据收集,分析坏疽性胆囊炎(GC)、急性(非坏疽性)胆囊炎(AC)和非急性胆囊切除术(NAC)之间的关系。结果:坏疽性胆囊炎25例,急性胆囊炎238例。我们发现GC患者明显变老(65.4岁比56.1岁(AC)和52.7岁(NAC), P < 0.05), M: F比更高(1.5:1比1:2.6 (AC)和1:2.8 (NAC), P < 0.05)。心脏病被发现是一个重要因素,而不是糖尿病。术前超声检查正确诊断急性炎性改变仅17例。7例患者超声检查无墨菲征。胆囊壁普遍较厚(4.11 mm vs 3.8 mm (AC)和2.7 mm (NAC), P < 0.05),但三组间有明显重叠。胆总管(CBD)更扩张(6.1 mm vs 4.8 mm (AC)和4.6 mm (NAC), P < 0.006), GC组的CBD结石发生率增加。我们的转换率为8.7%,并发症最少,无手术死亡率。结论:胃癌患者普遍年龄偏大,男性居多,心血管疾病发生率增高。术前超声不能准确识别坏疽性胆囊炎患者,但转换率为8.7%,无手术死亡率,一般可通过腹腔镜手术技术安全处理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Gangrenous cholecystitis in the laparoscopic era.

Background: We reviewed our data of laparoscopic cholecystectomies between 1990 and 1997 with reference to gangrenous cholecystitis.

Methods: In a consecutive series of 1304 patients having laparoscopic cholecystectomies, prospective data collection has permitted analysis of the relationship between gangrenous cholecystitis (GC), acute (non-gangrenous) cholecystitis (AC) and non-acute cholecystectomies (NAC).

Results: Twenty-five patients had gangrenous cholecystitis and 238 had acute cholecystitis. We found that patients with GC were significantly older (65.4 years vs 56.1 years (AC) and 52.7 years (NAC), P < 0.05) and had a higher M: F ratio (1.5:1 vs 1:2.6 (AC) and 1:2.8 (NAC), P < 0.05). Cardiac disease was found to be a significant factor but not diabetes. Preoperative ultrasonography correctly identified only 17 patients with acute inflammatory changes. Seven patients had an absent sonographic Murphy's sign. The gall bladder wall was generally thicker (4.11 mm vs 3.8 mm (AC) and 2.7 mm (NAC), P < 0.05) but there was marked overlap between the three groups. The common bile duct (CBD) was more dilated (6.1 mm vs 4.8 mm (AC) and 4.6 mm (NAC), P < 0.006) and there was increased incidence of CBD stones in the GC group. Our conversion rate was 8.7% with minimal complications and no operative mortality.

Conclusion: Patients with GC were generally older, more likely to be male and had increased incidence of cardiovascular disease. Preoperative ultrasound cannot accurately identify those patients with gangrenous cholecystitis, but with conversion rates of 8.7% and no operative mortality, they can generally be managed safely with laparoscopic surgical techniques.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信