Kapur B M, Mishra M C, Rao P S, Tandon R K
All India Institute of Medical Sciences, New Delhi.
HPB Surg. 1989 Oct;1(3):201-5. doi: 10.1155/1989/51967.
The medical records of 277 consecutive patients who underwent cholecystectomy for benign gall stone disease, were reviewed to determine the incidence and cause of biliary tract obstruction. Obstructive jaundice (icteric obstructive biliopathy) was present in 38 cases. This was due to choledocholithiasis in 22. Mirizzi's Syndrome in two, biliobiliary fistula in eight and biliary stricture in five patients. Preoperative direct cholangiography (ERCP/PIC) was helpful. Anicteric patients were classified on the basis of a history of jaundice serum alkaline phosphatase, sonography and operative findings. Anicteric patients with evidence of biliary tract pathology (anicteric obstructive biliopathy) had a significant incidence of choledocholithiasis (33.3%). Biliary complications were uncommon in this group (4.3%). Peroperative cholangiography was carried out and was valuable in these patients but was normal in all 83 patients who had no evidence of biliary obstruction.
回顾了277例因良性胆结石疾病接受胆囊切除术的连续患者的病历，以确定胆道梗阻的发生率和原因。38例患者出现梗阻性黄疸（黄疸性梗阻性胆管病）。其中22例是由于胆总管结石，2例是Mirizzi综合征，8例是胆胆瘘，5例是胆管狭窄。术前直接胆管造影（ERCP/PIC）很有帮助。无黄疸患者根据黄疸病史、血清碱性磷酸酶、超声检查和手术结果进行分类。有胆道病理证据的无黄疸患者（无黄疸性梗阻性胆管病）胆总管结石的发生率显著（33.3%）。该组胆道并发症不常见（4.3%）。进行了术中胆管造影，对这些患者很有价值，但在所有83例无胆道梗阻证据的患者中均正常。
