Braun L
Chirurg. 1987 Jun;58(6):413-7.
Between 1974 and 1986 2702 patients with benign disorders of the gallbladder or biliary tract have been treated operatively. The following procedures were preformed: cholecystectomy in 70.6%, choledochotomy and T-tube in 18.8%, biliodigestive anastomosis in 5.6%, transduodenal papillotomy in 3.3%, recurrent operation in 1.3%, and operation for gallstone ileus in 0.4%. 38 patients (1.4%) died within 30 days postoperatively. Mortality rates were: 0.6% for cholecystectomy, 2.6% for choledochotomy, 5.3% for biliodigestive anastomosis, 2.2% for transduodenal papillotomy, 8.8% for reoperations, and 0% for treatment of gallstone ileus. Postoperative mortality increased from 0.5% in patients younger than 50 years (0.1% for cholecystectomies) to 4.4% in patients older than 70 years (3.0% for cholecystectomies). With advancing age more complicated procedures were mandatory, while the female/male ratio declined significantly. An immediate operation for acute cholecystitis is indicated only in cases with perforated gallbladder or impending perforation.
1974年至1986年间,2702例患有胆囊或胆道良性疾病的患者接受了手术治疗。实施了以下手术:胆囊切除术占70.6%,胆总管切开术及置T管占18.8%,胆肠吻合术占5.6%,经十二指肠乳头切开术占3.3%,再次手术占1.3%,胆囊结石肠梗阻手术占0.4%。38例患者(1.4%)术后30天内死亡。死亡率分别为:胆囊切除术0.6%,胆总管切开术2.6%,胆肠吻合术5.3%,经十二指肠乳头切开术2.2%,再次手术8.8%,胆囊结石肠梗阻手术治疗为0%。术后死亡率从50岁以下患者的0.5%(胆囊切除术为0.1%)增至70岁以上患者的4.4%(胆囊切除术为3.0%)。随着年龄增长,必须实施更复杂的手术,而女性/男性比例显著下降。仅在胆囊穿孔或即将穿孔的情况下,才建议对急性胆囊炎立即进行手术。