Handler Chovav, Kaplan Uri, Hershko Dan, Abu-Hatoum Ossama, Kopelman Doron
Department of General Surgery, Ziv Medical Center, Rambam st, 13100, Tzfat, Israel.
Azrieli Faculty of Medicine, Bar-Ilan University, 8 Henrietta Szold st, Tzfat, Israel.
Eur J Trauma Emerg Surg. 2023 Apr;49(2):1157-1161. doi: 10.1007/s00068-022-02106-7. Epub 2022 Oct 5.
Patients who are admitted with acute cholecystitis (AC) and do not undergo urgent cholecystectomy, are usually referred for interval cholecystectomy. Many do not have surgery for various reasons, and some of those do not suffer from any recurrent symptoms. The primary objective of this study was to assess the rate and nature of recurrent gallstone-related events in this population over a long period, and its association with demographic and clinical parameters. A secondary objective was to assess the reasons for not undergoing surgery.
This is a retrospective cohort study, where the study group were adult patients admitted with AC. Patients that have suffered recurrent episodes were compared with those who did not. A control group of patients that had undergone cholecystectomy following an admission with AC was used for comparison. Demographic and clinical parameters were recorded for all patients, and the association with a recurrent episode was analyzed using univariate analysis.
The study population was 197 patients. The group of patients who did not undergo surgery were significantly older (68.7 vs 54.2) and sicker (ASA > 3 50% vs 19%). The rate of recurrent episodes in the study group was 38.5%, and it was not found to be associated with the studied parameters. There was a trend towards higher gallstone disease specific mortality in the study group (5.5% vs 1.45% p = 0.062).
This is a study of long-term follow-up of patients following an episode of AC we showed that the rate of recurrent episodes is quite high and involves severe inflammatory diseases, such as obstructive jaundice and pancreatitis.
因急性胆囊炎（AC）入院但未接受急诊胆囊切除术的患者，通常会被安排进行择期胆囊切除术。许多患者因各种原因未接受手术，其中一些患者并未出现任何复发症状。本研究的主要目的是评估该人群长期复发性胆结石相关事件的发生率及性质，及其与人口统计学和临床参数的关联。次要目的是评估未接受手术的原因。
这是一项回顾性队列研究，研究组为因AC入院的成年患者。将出现复发情况的患者与未复发的患者进行比较。选取一组因AC入院后接受胆囊切除术的患者作为对照组进行对比。记录所有患者的人口统计学和临床参数，并使用单因素分析来分析其与复发情况的关联。
研究人群为197例患者。未接受手术的患者组年龄显著更大（68.7岁对54.2岁）且病情更严重（ASA＞3 50%对19%）。研究组的复发率为38.5%，未发现其与所研究的参数相关。研究组胆结石疾病特异性死亡率有升高趋势（5.5%对1.45%，p = 0.062）。
这是一项对AC发作后患者的长期随访研究，我们发现复发率相当高，且涉及严重的炎症性疾病，如梗阻性黄疸和胰腺炎。
