Rambo W M, Reines H D
Am Surg. 1986 Apr;52(4):205-7.
Experience with elective cholecystectomy in ten patients with sickle cell disease and one patient with sickle-thalassemia from 1977-1984 was reviewed. In contrast to an earlier review from our institution, the current series had a low morbidity. This improvement is attributed to careful perioperative care, especially preoperative transfusion, hydration, and oxygenation. Because of the increasing longevity of sickle cell patients, because of the incidence of eventual significant complications of even asymptomatic cholelithiasis, and in order to simplify medical management by eliminating the diagnostic confusion between acute cholecystitis and sickle cell hepatobiliary crisis, the authors believe that elective cholecystectomy is to be recommended for the sickle cell patient with asymptomatic gall stones.
回顾了1977年至1984年间10例镰状细胞病患者和1例镰状细胞-地中海贫血患者接受择期胆囊切除术的经验。与我们机构早期的一项回顾不同,当前系列的发病率较低。这种改善归因于精心的围手术期护理,尤其是术前输血、补液和给氧。由于镰状细胞病患者的寿命延长,由于即使无症状胆结石最终也会出现严重并发症的发生率,并且为了通过消除急性胆囊炎和镰状细胞肝胆危象之间的诊断混淆来简化医疗管理,作者认为对于患有无症状胆结石的镰状细胞病患者,推荐进行择期胆囊切除术。