Division of Surgery, Fujinomiya City General Hospital, Shizuoka, Japan.
Division of Surgery, Fujinomiya City General Hospital, Shizuoka, Japan.
HPB (Oxford). 2019 Apr;21(4):508-514. doi: 10.1016/j.hpb.2018.09.007. Epub 2018 Oct 21.
There have been only a few reports that describe the long-term outcomes of Subtotal cholecystectomy (SC).
A total of 59 patients underwent "reconstituting" SC at our hospital between January 2005 and July 2017. In the 59 patients, risk factors for long-term complications were analyzed. In addition, in the patients with acute cholecystitis (AC), perioperative and long-term clinical factors were compared for patients who underwent SC (n = 48) and those who underwent total cholecystectomy (n = 378).
In the 59 patients who underwent SC, long-term complication developed in 14 (23.7%), including residual calculus in the common bile duct (n = 12), remnant cholecystitis (n = 1), and persistent severe inflammatory response (n = 1). Postoperative magnetic resonance image was performed in 35/59 patients (59.3%) who underwent SC. In these 35 patients, the size of the remnant gallbladder calculated by magnetic resonance cholangiopancreatography was significantly associated with the occurrence of long-term complications (p = 0.009). In the patients with AC, regarding long-term complications, the incidence of residual calculus in the common bile duct (16.6 versus 0.7%) was significantly higher in the SC group.
SC was associated with a relatively high incidence of long-term complications associated with remnant calculus.
仅有少数报道描述了次全胆囊切除术（SC）的长期结果。
2005 年 1 月至 2017 年 7 月，我院共对 59 例患者施行“重建”SC。对 59 例患者的长期并发症危险因素进行分析。此外，在急性胆囊炎（AC）患者中，比较了施行 SC（n=48）和行胆囊切除术（n=378）患者的围手术期和长期临床因素。
在施行 SC 的 59 例患者中，14 例（23.7%）发生长期并发症，包括胆总管残余结石（n=12）、残余胆囊炎（n=1）和持续性严重炎症反应（n=1）。对 59 例行 SC 的患者中的 35 例（59.3%）进行了术后磁共振成像检查。在这 35 例患者中，磁共振胰胆管成像计算的残余胆囊大小与长期并发症的发生显著相关（p=0.009）。在 AC 患者中，关于长期并发症，SC 组胆总管残余结石的发生率（16.6%比 0.7%）显著更高。
SC 与残余结石相关的长期并发症发生率相对较高。
