Bozhenkov Iu G, Kotsovskiĭ M I, Alekseev M V
Khirurgiia (Mosk). 1991 Nov(11):43-6.
Operations were performed on 15 patients with obturation gallstone ileus, 8 of them had a cholecystoduodenal fistula and the authors analysed their case records. It is most difficult to establish the diagnosis of the subacute form of the disease which is caused by slow movement of the stone in the intestine, which conceals the clinical picture and leads to delay of operation. The operation of choice is resection of the small intestine together with the stone or enterotomy with obligatory evacuation of contents from the proximal parts of the intestine. The mortality in the group of patients operated on later than on day 4 after the onset of the disease is very high and, according to our data, it is 100%. An obligatory condition of the operation is evacuation of the contents from the intestine in order to reduce intoxication and prevent endotoxic shock.
对15例闭塞性胆石性肠梗阻患者实施了手术,其中8例有胆囊十二指肠瘘,作者分析了他们的病例记录。最难确诊的是该病的亚急性形式,其由结石在肠道内移动缓慢引起,掩盖了临床表现并导致手术延迟。首选的手术方式是切除含有结石的小肠或进行肠切开术,并必须排空肠道近端的内容物。在疾病发作后第4天以后接受手术的患者组死亡率非常高,根据我们的数据,死亡率为100%。手术的一个必要条件是排空肠道内容物,以减轻中毒并预防内毒素休克。