Zbykovskaia L A
Vestn Khir Im I I Grek. 1975 Sep;114(9):25-30.
Due to some features in the clinical course of acute cholecystitis operative interventions may be performed in different terms. "Emergency" operations are performed on vital indications during the first day of patient's stay at the hospital; "urgent" operations are indicated, if there is no improvement in patients' status despite energetic conservative measures with antibiotics during 2-6 days. Delayed surgery is accomplished following the subsidence of clinical signs of the inflammatory process and adequate investigation of the object. Delay operations are certainly more advantageous, nevertheless in established diagnosis of suppurative inflammation in the gallbladder the expectation policy and persistant conservative therapy are hazardous because of a possibility of development of grave and multiple complications. A question of indications to emergency operations should be solved, if possible, during the first day of patients' stay at the hospital. According to the author's material the mortality rate after emergency operations was 3.1%, after urgent procedures--10%, and delayed operations--1.6%. An average per cent of the mortality in surgical therapy for acute cholecystitis makes 4.3%.
由于急性胆囊炎临床病程中的一些特点，手术干预可在不同时期进行。“急诊”手术在患者住院的第一天根据生命指征进行；“紧急”手术则是指尽管在2至6天内使用抗生素进行了积极的保守治疗，但患者状况仍无改善时进行。延期手术是在炎症过程的临床症状消退且对病变进行了充分检查之后进行。延期手术当然更具优势，然而，在已确诊胆囊化脓性炎症的情况下，期待策略和持续的保守治疗是危险的，因为可能会发生严重的多种并发症。急诊手术的指征问题应尽可能在患者住院的第一天解决。根据作者的资料，急诊手术后的死亡率为3.1%，紧急手术后为10%，延期手术后为1.6%。急性胆囊炎手术治疗的平均死亡率为4.3%。
