Yamasaki Yasushi, Takenaka Ryuta, Okazaki Noriko, Baba Yuki, Hamada Kenta, Takayama Hiroki, Takemoto Koji, Taira Akihiko, Tsugeno Hirofumi, Kubota Yasuhiro, Hayashi Doufu, Fujiki Shigeatsu
Department of Internal Medicine, Tsuyama Central Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2013 Oct;110(10):1774-82.
We monitored the management of acute cholecystitis in a rural area of Japan to determine the effectiveness of new guidelines for the management of acute cholecystitis and cholangitis. Between January 2000 and September 2011, 366 patients were treated for acute cholecystitis. Of these, 59 had common bile duct stones (CBDS) and 307 did not. Patients in both groups were further subdivided into two groups: a before guidelines group (BGG; n=153) and an after guideline group (AGG; n=154). Among the patients without CBDS, early cholecystectomy was more common in the AGG group (n=53) than in the BGG group. Furthermore, the length of hospital stay was four days shorter in the AGG group than in the BGG group (n=23). Among the patients with CBDS, the timing of cholecystectomy after endoscopic retrograde cholangiography was seven days earlier in the AGG group than in the BGG group. Even in a rural area of Japan, early cholecystectomy appears safe and can decrease the length of hospital stay.
我们监测了日本一个农村地区急性胆囊炎的治疗情况，以确定急性胆囊炎和胆管炎新治疗指南的有效性。2000年1月至2011年9月期间，366例患者接受了急性胆囊炎治疗。其中，59例有胆总管结石（CBDS），307例没有。两组患者又进一步分为两组：指南前组（BGG；n = 153）和指南后组（AGG；n = 154）。在无CBDS的患者中，AGG组（n = 53）早期胆囊切除术比BGG组更常见。此外，AGG组的住院时间比BGG组短4天（n = 23）。在有CBDS的患者中，内镜逆行胆管造影术后胆囊切除术的时间，AGG组比BGG组早7天。即使在日本的农村地区，早期胆囊切除术似乎也是安全的，并且可以缩短住院时间。
