Uspenskiĭ L V, Kurguzov O P, Kuzin N M, Kuznetsov N A, Levkin V V
Khirurgiia (Mosk). 1989 Oct(10):60-5.
Experience in combined operations for cholelithiasis on 162 patients is discussed. In 98 patients, cholecystectomy was performed as a simultaneous stage of surgical treatment, the main stage of the operation was gastrectomy or resection of the stomach for cancer in 26 patients, formation of a small stomach for alimentary-constitutional obesity in 19, various types of vagotomy in 33, hemicolectomy, resection of the colon and sigmoid intestine for malignant tumors in 10, and reconstructive manipulations on the stomach, correction of intestinal obstruction, and other operations in 10 patients. Cholecystectomy was the main stage of the operation in 48 patients with hernias, benign tumors of the uterine appendages, breasts, and soft tissues. The authors insist that cholecystectomy must be carried out when cholelithiasis is a concurrent disease; they showed that increase in the extent of the operative intervention had no essential effect on mortality and frequency of postoperative complications (mortality rate, 1.2%). The authors substantiate the expediency of performing combined operations from economical considerations--the economical effect of the operations conducted by the authors came to some 51,000 roubles.
本文讨论了162例胆结石联合手术的经验。98例患者在手术治疗的同时进行了胆囊切除术,其中26例患者手术的主要阶段是胃癌切除术或胃切除手术,19例患者为治疗营养性体质肥胖症进行了小胃形成术,33例患者进行了各种类型的迷走神经切断术,10例患者为恶性肿瘤进行了半结肠切除术、结肠和乙状结肠切除术,10例患者进行了胃部重建手术、肠梗阻矫正手术及其他手术。48例患有疝气、子宫附件良性肿瘤、乳腺和软组织良性肿瘤的患者,手术的主要阶段是胆囊切除术。作者坚持认为,当胆结石为并发疾病时必须进行胆囊切除术;他们指出,手术干预范围的扩大对死亡率和术后并发症发生率没有实质性影响(死亡率为1.2%)。作者从经济角度论证了进行联合手术的合理性——作者所做的手术产生的经济效益约为51,000卢布。