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急性胆囊炎的描述性综述:日本-台湾合作流行病学研究

Descriptive review of acute cholecystitis: Japan-Taiwan collaborative epidemiological study.

作者信息

Yokoe Masamichi, Takada Tadahiro, Hwang Tsann-Long, Endo Itaru, Akazawa Kohei, Miura Fumihiko, Mayumi Toshihiko, Mori Rintaro, Chen Miin-Fu, Jan Yi-Yin, Ker Chen-Guo, Wang Hsiu-Po, Itoi Takao, Gomi Harumi, Kiriyama Seiki, Wada Keita, Yamaue Hiroki, Miyazaki Masaru, Yamamoto Masakazu

机构信息

Department of General Internal Medicine, Japanese Red Cross Nagoya Daini Hospital, Aichi, Japan.

Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.

出版信息

J Hepatobiliary Pancreat Sci. 2017 Jun;24(6):319-328. doi: 10.1002/jhbp.450. Epub 2017 May 14.

Abstract

BACKGROUND

Since the publication of the Tokyo Guidelines (TG13) for the management of acute cholecystitis (AC), multidirectional studies have been published. However, epidemiological research about AC with big data was not projected. The aim of this study was to reveal the actual clinical conditions of AC.

METHOD

The study was designed as an international multicenter retrospective study of AC in Japan and Taiwan from 2011 to 2013. The factors investigated comprised data related to demographic, history, physical examinations, laboratory and imaging findings. Based on these data, we investigated the various values of AC, and real situation with respect to severity and treatment.

RESULTS

A total of 5,459 patients with AC were reviewed. Thirty-day mortality rate was 1.1%. Based on the diagnostic criteria, 4,088 patients had a definite diagnosis and 291 had a suspected diagnosis. According to the severity grading, 939 patients were classified as Grade III, 2,308 as Grade II, and 2,130 as Grade I. Cholecystectomy was performed in total of 4,266 patients and 2,765 patients had laparoscopic cholecystectomy. The main etiologies were gallbladder stones in 4,623 cases.

CONCLUSION

This epidemiological study with large population will undoubtedly contribute to establish the best practice for managing AC worldwide.

摘要

背景

自急性胆囊炎(AC)管理的东京指南(TG13)发布以来,已发表了多方面的研究。然而,尚未开展关于AC的大数据流行病学研究。本研究的目的是揭示AC的实际临床情况。

方法

本研究设计为一项针对2011年至2013年日本和台湾地区AC的国际多中心回顾性研究。所调查的因素包括与人口统计学、病史、体格检查、实验室及影像学检查结果相关的数据。基于这些数据,我们调查了AC的各项指标以及严重程度和治疗方面的实际情况。

结果

共纳入5459例AC患者进行分析。30天死亡率为1.1%。根据诊断标准,4088例患者确诊,291例疑似诊断。根据严重程度分级,939例患者为Ⅲ级,2308例为Ⅱ级,2130例为Ⅰ级。总共4266例患者接受了胆囊切除术,其中2765例患者接受了腹腔镜胆囊切除术。主要病因是胆囊结石,共4623例。

结论

这项大规模人群的流行病学研究无疑将有助于确立全球范围内AC管理的最佳实践。

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