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诊断为慢性胆囊炎并行胆囊切除术患者的脓胸、黏液囊肿或其他组织学诊断的患病率。

Prevalence of Empyema or Mucocele or Other Histological Diagnoses in Patients Undergoing Cholecystectomy With Diagnosis of Chronic Cholecystitis.

作者信息

Murtaza Khomusi Munira, Parveen Sughra, Iqbal Mazhar, Ahmed Tanweer, Husain Razia, Shamim Seth Uzma, Soomro Jehangir Ali, Sariyah Khan Zainab

机构信息

Surgical Ward 1, Jinnah Postgraduate Medical Centre, Karachi, PAK.

Surgical Ward 2, Jinnah Postgraduate Medical Centre, Karachi, PAK.

出版信息

Cureus. 2022 Apr 3;14(4):e23773. doi: 10.7759/cureus.23773. eCollection 2022 Apr.

Abstract

Background Chronic cholecystitis is inflammation of the gall bladder usually caused by stones. The aim was to find out the prevalence of mucocele and empyema in chronic cholecystitis using cholecystectomy findings and histopathological reports. Methodology This was a cross-sectional observational study conducted in Surgical Ward 1, Jinnah Postgraduate Medical Center, Karachi from December 2019 to December 2021 for two years. Patients above 12 years of age diagnosed with chronic cholecystitis with cholelithiasis on clinical examination and investigations were included. Patients who were diagnosed with acute cholecystitis, mucocele, or empyema on clinical examination and ultrasonography were excluded from the study. Laparoscopic cholecystectomy was done and operative findings were noted. Gall bladder specimens were examined for mucocele and empyema and were sent for histopathology. Results were recorded and analyzed. Results There were 241 patients diagnosed with chronic cholecystitis with cholelithiasis on clinical examination and investigations. On examination, tenderness in the right hypochondrium was absent in all patients. Chronic cholecystitis was proved on histopathology in 231 patients (95.85%). Other findings diagnosed on peroperative findings and histopathology reports were strawberry gall bladder (2.41%), empyema (0.83%), mucocele (0.41%), and polyp (0.41%). Two hundred eight patients were female (86.31%), 33 were male(13.69%). The male to female ratio was 1:6.43. The average age was 31 years. Conclusion Inflammation and fibrosis of the gallbladder around Calot's triangle increase the chances of vascular and common bile duct injury. In such cases, cholecystectomy can become difficult. It was concluded that empyema, mucocele, and strawberry gall bladder could be found in chronic cholecystitis, and cholecystectomy becomes difficult in such cases.

摘要

背景

慢性胆囊炎是胆囊的炎症,通常由结石引起。目的是利用胆囊切除术的结果和组织病理学报告,了解慢性胆囊炎中胆囊积脓和胆囊黏液囊肿的患病率。方法:这是一项横断面观察性研究,于2019年12月至2021年12月在卡拉奇真纳研究生医学中心第一外科病房进行,为期两年。纳入临床检查和调查诊断为慢性胆囊炎伴胆石症的12岁以上患者。临床检查和超声检查诊断为急性胆囊炎、胆囊黏液囊肿或胆囊积脓的患者被排除在研究之外。进行腹腔镜胆囊切除术并记录手术结果。检查胆囊标本是否存在胆囊积脓和胆囊黏液囊肿,并送去做组织病理学检查。记录并分析结果。结果:临床检查和调查诊断为慢性胆囊炎伴胆石症的患者有241例。检查时,所有患者右季肋区均无压痛。231例患者(95.85%)经组织病理学证实为慢性胆囊炎。手术结果和组织病理学报告诊断的其他结果为草莓样胆囊(2.41%)、胆囊积脓(0.83%)、胆囊黏液囊肿(0.41%)和息肉(0.41%)。208例患者为女性(86.31%),33例为男性(13.69%)。男女比例为1:6.43。平均年龄为31岁。结论:胆囊三角周围胆囊的炎症和纤维化增加了血管和胆总管损伤的几率。在这种情况下,胆囊切除术可能会变得困难。得出的结论是,慢性胆囊炎中可发现胆囊积脓、胆囊黏液囊肿和草莓样胆囊,在这种情况下胆囊切除术会变得困难。

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