Popov Iu P, Eremeev V A, Skopin M S, Khasan A Sh
Khirurgiia (Mosk). 2006(1):49-52.
Results of treatment of 43 patients with acute intestinal obstruction due to gall-stones are analyzed. Forty patients were operated, 3 patients were not because of extremely severe state. Enterolythotomy was performed in 27 cases, incision of intestinal wall was carried out directly above the stones (14 cases, group 1), above or below it (13 cases, group 2). Insufficiency of enteral suture was seen in 4 patients of group 1 that required repeated surgery. Lethality in group 1 was 21.4%, in group 2-7.1%. Intestinal resection was performed in 12 patients of group 3, there were no cases of suture insufficiency, and lethality was 8.3%. It is concluded that enterotomy should be performed above or below strangulated stone. Intestinal resection should be performed when concrement is immovable or in cases of intestinal necrosis.
对43例因胆结石导致急性肠梗阻患者的治疗结果进行了分析。40例患者接受了手术,3例因病情极其严重未进行手术。27例患者进行了肠切开取石术,在结石正上方进行肠壁切开(14例,第1组),在结石上方或下方切开(13例,第2组)。第1组有4例患者出现肠缝合不足,需要再次手术。第1组的死亡率为21.4%,第2组为7.1%。第3组12例患者进行了肠切除术,没有出现缝合不足的情况,死亡率为8.3%。结论是,应在绞窄性结石上方或下方进行肠切开术。当结石无法移动或出现肠坏死时,应进行肠切除术。