Saeed Asif, Nawaz Muhammad, Noreen Aysha, Ahmad Sarfraz
Department of Surgery, Women Medical College, Abbottabad, Pakistan.
J Ayub Med Coll Abbottabad. 2010 Jul-Sep;22(3):182-4.
Cholelithiasis is a common disorder affecting the females more commonly. Most of the population carrying the gallstones remains asymptomatic, however biliary colic and acute cholecystitis is a common complication. Most surgeons agree that early cholecystectomy is safe and should be the procedure of choice in acute cholecystitis. Objective of this study was to determine the frequency of patients with acute cholecystitis, and morbidity and mortality in such cases.
A prospective study, conducted at DHQ Hospital Abbottabad, and Yahya Welfare Hospital, Haripur simultaneously on 162 patients having symptomatic gall stones. All patients were admitted on presentation and surgical intervention done within 72 hours on patients fit for surgery. Patients with cardiac problem, HCV positive, and with radiologic evidence of Common Bile Duct (CBD) stones were excluded. Ultrasonography abdomen was the main investigation.
Postoperative complications, hospital stay and return to routine activities was evaluated. The postoperative complications were seroma formation in 3 cases (1.9%), liver trauma resulting in bleeding and prolonged hospital stay in 1 case (0.6%). In 1 patient stones slipped into CBD resulting in CBD exploration.
Early cholecystectomy with upper right transverse incision and muscle retraction in acute cholecystitis is a safe, and cost effective procedure with fewer complications, better cosmesis and early return to work.
胆石症是一种常见疾病，女性更为多发。大多数携带胆结石的人并无症状，然而胆绞痛和急性胆囊炎是常见并发症。大多数外科医生认为早期胆囊切除术是安全的，且应是急性胆囊炎的首选治疗方法。本研究的目的是确定急性胆囊炎患者的发病率以及此类病例中的发病率和死亡率。
在阿伯塔巴德的DHQ医院和哈里普尔的亚希亚福利医院同时对162例有症状胆结石患者进行了一项前瞻性研究。所有患者就诊时均入院，适合手术的患者在72小时内进行手术干预。排除有心脏问题、丙肝病毒阳性以及有胆总管结石放射学证据的患者。腹部超声检查是主要的检查手段。
对术后并发症、住院时间和恢复日常活动情况进行了评估。术后并发症包括3例（1.9%）出现血清肿，1例（0.6%）因肝损伤导致出血和住院时间延长。1例患者结石滑入胆总管，因此进行了胆总管探查。
在急性胆囊炎中采用右上横切口和肌肉牵开的早期胆囊切除术是一种安全且经济有效的手术，并发症较少，美容效果更好，能早期恢复工作。
