Evans W E, Hayes J P, Waltke E A, Kleckner S C
Department of Surgery, Saint Anthony Medical Center, Columbus, Ohio 43205.
Am J Surg. 1989 Feb;157(2):208-9. doi: 10.1016/0002-9610(89)90529-1.
A study was undertaken to determine the value of preoperative oral cholecystography and the incidence and complications of cholelithiasis in patients undergoing aortic reconstruction. Over an 11-year period, 785 patients underwent aortic reconstruction. Forty-seven had a previous cholecystectomy; of the 738 remaining patients, 394 underwent preoperative operative oral cholecystography to screen for cholelithiasis. Seventy-three (18 percent) were found to have gallbladder disease. Thirteen had symptoms attributed to cholelithiasis and underwent cholecystectomy with aortic reconstruction. Three hundred eighty-one were left with the gallbladder after aortic reconstruction, 60 in whom disease was identified and 321 with normal oral cholecystography results. Three patients developed cholecystitis in the postoperative period, one in the diseased group and two with normal gallbladders. The incidence of postoperative cholecystitis was 0.8 percent (3 patients). Preoperative oral cholecystography is of little value as a screening tool. Cholecystectomy during aortic reconstruction is probably safe and the risk of postoperative cholecystitis in the asymptomatic patient is negligible.
一项研究旨在确定术前口服胆囊造影的价值以及接受主动脉重建手术患者的胆石症发病率和并发症情况。在11年期间，785例患者接受了主动脉重建手术。47例曾接受过胆囊切除术；在其余738例患者中，394例接受了术前口服胆囊造影以筛查胆石症。发现73例（18%）患有胆囊疾病。13例有胆石症相关症状，在接受主动脉重建手术时同时进行了胆囊切除术。381例在主动脉重建术后保留了胆囊，其中60例被发现患有疾病，321例口服胆囊造影结果正常。3例患者在术后发生胆囊炎，1例在患病组，2例胆囊正常。术后胆囊炎的发生率为0.8%（3例患者）。术前口服胆囊造影作为一种筛查工具价值不大。在主动脉重建手术期间进行胆囊切除术可能是安全的，无症状患者术后发生胆囊炎的风险可忽略不计。
