胆囊切除术在肾移植中的作用。
The role of cholecystectomy in renal transplantation.
作者信息
Sianesi M, Capocasale E, Ferreri G, Mazzoni M P, Dalla Valle R, Busi N
机构信息
Department of Surgery, Institute of General Surgery and Organ Transplantation, University of Parma, Enzi Capocasale, Via Bizzozero 7, 43100 Parma, Italy.
出版信息
Transplant Proc. 2005 Jun;37(5):2129-30. doi: 10.1016/j.transproceed.2005.03.028.
INTRODUCTION
We reviewed our clinical experience to assess the role of cholecystectomy transplant candidates pre- and posttransplantation.
METHODS
Between April 1986 and December 2003, 57 (6.8%) candidates among 839 kidney transplants were found during routine pretransplant screening to show gallstones.
RESULTS
Thirty nine (68.4%) symptomatic patients underwent cholecystectomy before transplantation. Among 18 (31.6%) asymptomatic patients monitored after transplantation, the 7 (39%) who developed biliary tract symptoms underwent laparoscopy or minilaparocholecystectomy without postoperative morbidity, mortality, or graft loss.
CONCLUSIONS
Symptomatic gallstones have to be treated using the laparoscopic cholecystectomy or minilaparotomy technique. In asymptomatic cholelithiasis prophylactic cholecystectomy is only reserved for patients with biliary "intrinsic" risk factors. An early diagnosis and prompt surgical treatment yields good results.
引言
我们回顾了我们的临床经验，以评估胆囊切除术在移植候选者移植前后的作用。
方法
在1986年4月至2003年12月期间，839例肾移植候选者在常规移植前筛查中发现57例（6.8%）有胆结石。
结果
39例（68.4%）有症状的患者在移植前接受了胆囊切除术。在移植后监测的18例（31.6%）无症状患者中，7例（39%）出现胆道症状，接受了腹腔镜或小切口胆囊切除术，术后无发病率、死亡率或移植物丢失。
结论
有症状的胆结石必须采用腹腔镜胆囊切除术或小切口剖腹术技术治疗。对于无症状胆结石，预防性胆囊切除术仅适用于有胆道“内在”危险因素的患者。早期诊断和及时手术治疗可取得良好效果。
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