Al-Mulhim Abdulrahman Saleh, Al-Mulhim Faisal Mohammed, Al-Suwaiygh Abdulmohsen Abdulla
Department of Surgery, King Fahad Hospital, Hofuf, Al Hassa, Saudi Arabia.
Am J Surg. 2002 Jun;183(6):668-72. doi: 10.1016/s0002-9610(02)00872-3.
As emergency surgery in sickle cell disease patients is associated with high morbidity, the aim of the study was to assess the safety of laparoscopic cholecystectomy in the acute state for these patients.
Over a 5-year period, April 1994 till December 1998, 35 sickle cell patients with acute cholecystitis had laparoscopic cholecystectomy within the first 5 days of presentation. A retrospective study of these was undertaken.
Thirty-five patients were diagnosed as having acute cholecystitis with sickle cell disease. There were 26 female and 9 male patients; 5 patients needed preoperative and 1 patient needed postoperative endoscopic retrograde cholangiopancreatography. Twenty-seven patients needed simple transfusion and 8 needed partial exchange; conversion was necessary in two cases (5.7%). The mean hospital stay was 5.3 days and the complication rate was 17.5%.
Because of the lack of significant complications, we believe that laparoscopic cholecystectomy for acute cholecystitis is safe and recommended in experienced hands with adequate preoperative preparation for patients with sickle cell disease.
由于镰状细胞病患者进行急诊手术的发病率较高，本研究旨在评估这些患者在急性期行腹腔镜胆囊切除术的安全性。
在1994年4月至1998年12月的5年期间，35例患有急性胆囊炎的镰状细胞病患者在就诊后的前5天内接受了腹腔镜胆囊切除术。对这些患者进行了回顾性研究。
35例患者被诊断为患有镰状细胞病合并急性胆囊炎。其中女性26例，男性9例；5例患者需要术前内镜逆行胰胆管造影，1例患者需要术后内镜逆行胰胆管造影。27例患者需要单纯输血，8例需要部分换血；2例（5.7%）需要中转开腹。平均住院时间为5.3天，并发症发生率为17.5%。
由于没有明显并发症，我们认为对于镰状细胞病患者，在经验丰富的医生操作并进行充分术前准备的情况下，急性胆囊炎行腹腔镜胆囊切除术是安全的，值得推荐。
