存在大的卵圆孔未闭时行胆囊切除术：腹腔镜还是开腹？

Cholecystectomy in the presence of a large patent foramen ovale: laparoscopic or open?

机构信息

Department of Anesthesia and Perioperative Care, the University of California, San Francisco, CA 94143-0648, USA.

出版信息

J Clin Anesth. 2010 Nov;22(7):553-6. doi: 10.1016/j.jclinane.2009.09.011.

DOI:10.1016/j.jclinane.2009.09.011

Abstract

An obese patient with cholelithiasis and acute cholecystitis was scheduled for an emergency laparoscopic cholecystectomy. On preoperative workup, a 5-year-old echocardiogram showed a large patent foramen ovale (PFO) with a right-to-left shunt that was open at rest. Noting both the benefits of laparoscopic surgery and the substantial incidence of PFO in the general population (10% to 30%), the attending and consulting surgeons reasoned that the benefits of laparoscopy greatly exceeded an immeasurably small risk of paradoxical emboli.

摘要

一位肥胖的胆石症和急性胆囊炎患者被安排进行紧急腹腔镜胆囊切除术。在术前检查中，5 年前的超声心动图显示一个大的卵圆孔未闭（PFO），存在右向左分流，在休息时开放。考虑到腹腔镜手术的益处和卵圆孔未闭在普通人群中的高发病率（10%至 30%），主治医生和顾问外科医生认为腹腔镜手术的益处大大超过了无法估量的小的矛盾栓塞风险。