Lorusso D, Pezzolla F, Guerra V, Giorgio I
Divisione di Chirurgia, Istituto Scientifico Gastroenterologico S. De Bellis, Castellana Grotte, Bari.
Minerva Chir. 1992 May 15;47(9):843-6.
A retrospective case-control study was carried out to assess whether additional cholecystectomy in patients undergoing digestive surgery caused increased postoperative morbidity and mortality. During the period 1983-90, 70 patients underwent cholecystectomy at the same time as other surgery (25 gastric resections, 23 colon resections, 17 total gastrectomies, 2 fundoplicatio using Nissen's technique, 2 cases of Heller's operation, 1 truncular vagotomy and pyloroplasty). These cases were matched for sex, age (+/- 5 years) and type of primary operation with 70 controls (patients without additional cholecystectomy). Complications were significantly more frequent among the former group compared to controls (28.6% vs 11.4%, p = 0.02), in particular in the group of patients undergoing colon resection (34.8% vs 8.7%, p = 0.04). The frequencies of reoperation and mortality were also higher in patients undergoing additional cholecystectomy than in controls (10% vs 1.4%), but the difference was not statistically significant (p = 0.06). In conclusion, additional cholecystectomy during digestive surgery increases the risk of postoperative complications, in particular in colorectal surgery.
开展了一项回顾性病例对照研究，以评估在接受消化手术的患者中额外进行胆囊切除术是否会导致术后发病率和死亡率增加。在1983年至1990年期间，70例患者在进行其他手术的同时接受了胆囊切除术（25例胃切除术、23例结肠切除术、17例全胃切除术、2例采用nissen技术的胃底折叠术、2例 heller手术、1例迷走神经干切断术和幽门成形术）。这些病例在性别、年龄（±5岁）和初次手术类型方面与70例对照（未进行额外胆囊切除术的患者）进行匹配。与对照组相比，前一组的并发症明显更频繁（28.6%对11.4%，p = 0.02），特别是在接受结肠切除术的患者组中（34.8%对8.7%，p = 0.04）。接受额外胆囊切除术的患者再次手术和死亡率的频率也高于对照组（10%对1.4%），但差异无统计学意义（p = 0.06）。总之，消化手术期间额外进行胆囊切除术会增加术后并发症的风险，尤其是在结直肠手术中。
