Bredesen J, Jørgensen T, Andersen T F, Brønnum-Hansen H, Roepstorff C, Madsen M, Wille-Jørgensen P, Loft A
Department of Surgical Gastroenterology F, Bispebjerg Hospital, University of Copenhagen, Denmark.
World J Surg. 1992 May-Jun;16(3):530-5. doi: 10.1007/BF02104463.
This paper assesses the risk of dying within 30 days of admission among 13,854 women who had a cholecystectomy performed as the principal operation from 1977 to 1981. The overall crude mortality rate was 1.2%. Women who had a simple elective cholecystectomy performed had a mortality rate similar to women who had a simple hysterectomy. The mortality was significantly higher than in the general female population (p less than 0.05). Increased age, acute admission, admissions to hospital within 3 months prior to the index admission, the number of discharge diagnoses, and the geographical region were significantly associated with increased mortality. Exploration of the common bile duct was associated with higher mortality in the bivariate analysis, but the association disappeared when the number of discharge diagnoses was taken into account. Type of hospital and the population based cholecystectomy rate of the patient's residential area was not associated with mortality. As regards early mortality, it is concluded that simple elective cholecystectomy is a safe procedure before the age of 50 to 60 years. Acute admissions and more than one diagnosis at discharge were associated with an increased mortality, whereas exploration of the common bile duct may not be as important an independent factor as previously assumed.
本文评估了1977年至1981年间接受胆囊切除术作为主要手术的13854名女性患者入院后30天内的死亡风险。总体粗死亡率为1.2%。接受单纯择期胆囊切除术的女性死亡率与接受单纯子宫切除术的女性相似。该死亡率显著高于普通女性人群（p<0.05）。年龄增加、急性入院、本次入院前3个月内曾入院、出院诊断数量以及地理区域与死亡率增加显著相关。在双变量分析中，胆总管探查与较高的死亡率相关，但在考虑出院诊断数量后，这种关联消失了。医院类型和患者居住地区的基于人群的胆囊切除术率与死亡率无关。关于早期死亡率，得出的结论是，单纯择期胆囊切除术在50至60岁之前是一种安全的手术。急性入院和出院时存在不止一项诊断与死亡率增加相关，而胆总管探查可能并不像之前认为的那样是一个重要的独立因素。
