Ameli F M, Weiss M, Provan J L, Johnston K W
Can J Surg. 1987 May;30(3):170-3.
Many surgeons are reluctant to remove asymptomatic gallstones during aortic reconstruction for fear of increasing the risk of graft infection. This is a review of 56 patients who underwent aortofemoral bypass or aortic aneurysm repair, with cholecystectomy, to determine if the morbidity or mortality was increased with the concomitant procedure. Follow-up averaged 25 months (range from 1 to 125 months). Three patients were lost to follow-up. Operative and postoperative hospital stay were not increased. One patient suffered a graft infection and a pseudoaneurysm; the infection was not related to the cholecystectomy since it occurred after a secondary procedure for repair of an infected false aneurysm. There were three superficial infections and three postoperative deaths, none of which specifically related to the cholecystectomy. The only related complications were three bile leaks, one liver injury due to a retractor and bleeding from the gallbladder bed in one patient who required reoperation. The authors conclude that concomitant cholecystectomy can be performed without increased risk to the patient but is advised only if the vascular procedure has been uncomplicated and the cholecystectomy appears straightforward.
许多外科医生在进行主动脉重建时不愿切除无症状胆结石，因为担心会增加移植感染的风险。本文回顾了56例行主-股动脉旁路移植术或主动脉瘤修复术并同时行胆囊切除术的患者，以确定同期手术是否会增加发病率或死亡率。随访平均25个月（范围为1至125个月）。3例患者失访。手术时间和术后住院时间并未延长。1例患者发生移植感染和假性动脉瘤；感染与胆囊切除术无关，因为它发生在修复感染性假性动脉瘤的二次手术后。有3例表浅感染和3例术后死亡，均与胆囊切除术无明确关联。唯一相关的并发症是3例胆漏、1例因牵开器导致的肝损伤以及1例需要再次手术的患者胆囊床出血。作者得出结论，同期行胆囊切除术不会增加患者风险，但仅在血管手术无并发症且胆囊切除术看似简单时建议进行。
