Ziv Y, Feigenberg Z, Zer M, Dintsman M
Department of Surgery A, Beilinson Medical Center, Petah Tikva, Israel.
Am J Gastroenterol. 1987 Nov;82(11):1165-8.
The phenomenon of acute cholecystitis complicating an unrelated operation has been reported with increasing frequency, and may be preceded by a variety of operative procedures and a lack of previous biliary tract symptoms. Among eight such patients treated by us, seven developed acute cholecystitis postoperatively, and in one it was discovered during operation for bleeding duodenal ulcer. Two patients had undergone wide excision of the breast; two, highly selective vagotomy; one, nephrolithotomy; one, truncal vagotomy and gastroenterostomy; and one, left hemicolectomy and colostomy. In three patients, urgent cholecystectomy was performed, and four were treated conservatively with subsequent elective cholecystectomy. Histopathological studies revealed acute and chronic cholecystitis in all eight patients and cholelithiasis in four. One patient died in septic shock. Numerous contributing factors have been suggested, including hypovolemia and biliary stasis, as well as the presence of stones. It would appear that chronic cholecystitis or other biliary pathology, as found in our eight patients, is a major factor in the development of this manifestation.
急性胆囊炎并发非相关手术的现象报道频率日益增加，且可能先于各种手术操作出现，且之前无胆道症状。在我们治疗的8例此类患者中，7例术后发生急性胆囊炎，1例在十二指肠溃疡出血手术中被发现。2例患者接受了乳房广泛切除术；2例接受了高选择性迷走神经切断术；1例接受了肾切开取石术；1例接受了迷走神经干切断术和胃肠吻合术；1例接受了左半结肠切除术和结肠造口术。3例患者接受了急诊胆囊切除术，4例接受了保守治疗，随后择期行胆囊切除术。组织病理学研究显示，所有8例患者均有急慢性胆囊炎，4例有胆石症。1例患者死于感染性休克。已提出许多促成因素，包括血容量不足和胆汁淤积以及结石的存在。在我们的8例患者中发现的慢性胆囊炎或其他胆道病变似乎是这种表现发生的主要因素。
