Farr R Wesley, Kane Paul D
Naval Aerospace Medical Institute, Pensacola, FL 32508, USA.
Aviat Space Environ Med. 2002 Jul;73(7):681-3.
This study examines the aeromedical outcomes of aviation personnel with asymptomatic cholelithiasis or those treated successfully with conventional (open) cholecystectomy (CC), laparoscopic cholecystectomy (LC), or extracorporeal shock wave lithotripsy (ESWL) for previous symptomatic cholecystitis.
The Biomedical Database of the Naval Aerospace Medical Institute was searched for waiver requests for asymptomatic gallstones, acute cholecystitis, and cholecystectomy. Microfiche records were then reviewed. The rates of development of symptomatic disease and need for cholecystectomy or ESWL were noted in aircrew granted waivers for asymptomatic cholelithiasis. The aeromedical outcomes of aircrew who underwent treatment for symptomatic disease by cholecystectomy (CC or LC) or ESWL were reviewed.
A search of the Biomedical Database revealed waiver requests for cholelithiasis for 79 naval aviation personnel from April 1988 to August 2000. Waiver requests were for previous cholecystectomy in 56 (70.9%) and cholelithiasis in 23 (29.1%). No aviators had undergone ESWL. Of the 56 aviators with previous cholecystectomy, waivers were granted in 51 (91.1%) cases. Waivers were denied to five individuals, primarily for other medical problems. Of the 23 aviators with cholelithiasis, 11 (47.8%) were granted waivers. Waivers were denied in 12 aviators because of symptomatic cholelithiasis (5), asymptomatic cholelithiasis (1), common bile duct stone (1), other medical problems (3), or no explanation (2). The aviator with asymptomatic cholelithiasis and two of the aviators with symptomatic cholelithiasis were subsequently granted waivers after cholecystectomy (LC). The aviator with a symptomatic common bile duct stone received a waiver after cholecystectomy (CC). A total of 66 (83.5%) aviators received waivers. None were revoked during the study period because of symptomatic cholelithiasis or retained common bile duct stones.
Aviation personnel who receive waivers for asymptomatic cholelithiasis or cholecystectomy rarely present with symptomatic biliary disease.
本研究探讨了无症状胆结石的航空人员或曾因有症状胆囊炎而接受传统(开放)胆囊切除术(CC)、腹腔镜胆囊切除术(LC)或体外冲击波碎石术(ESWL)治疗且治疗成功的航空人员的航空医学结局。
检索海军航空医学研究所生物医学数据库中关于无症状胆结石、急性胆囊炎和胆囊切除术的豁免申请。然后查阅缩微胶片记录。记录给予无症状胆结石豁免的机组人员中出现有症状疾病以及需要进行胆囊切除术或ESWL的发生率。回顾接受胆囊切除术(CC或LC)或ESWL治疗有症状疾病的机组人员的航空医学结局。
对生物医学数据库的检索显示,1988年4月至2000年8月期间有79名海军航空人员申请胆结石豁免。豁免申请中,56人(70.9%)为既往胆囊切除术,23人(29.1%)为胆结石。无人接受过ESWL治疗。在56名既往有胆囊切除术的飞行员中,51人(91.1%)获得豁免。5人豁免申请被拒,主要是因为其他医疗问题。在23名有胆结石的飞行员中,11人(47.8%)获得豁免。12名飞行员豁免申请被拒,原因包括有症状胆结石(5例)、无症状胆结石(1例)、胆总管结石(1例)、其他医疗问题(3例)或未说明原因(2例)。无症状胆结石的飞行员以及2名有症状胆结石的飞行员在接受胆囊切除术(LC)后随后获得豁免。有症状胆总管结石的飞行员在接受胆囊切除术(CC)后获得豁免。共有66名(83.5%)飞行员获得豁免。在研究期间,无人因有症状胆结石或残留胆总管结石而被撤销豁免。
获得无症状胆结石或胆囊切除术豁免的航空人员很少出现有症状的胆道疾病。