地区综合医院中梗阻性黄疸的外科治疗
Surgical relief of obstructive jaundice in a district general hospital.
作者信息
Al-Fallouji M A, Collins R E
出版信息
J R Soc Med. 1985 Mar;78(3):211-6. doi: 10.1177/014107688507800308.
Fifty consecutive patients with obstructive jaundice treated by operation in Canterbury & Thanet Health District hospitals under the care of one surgeon (RECC) over a 6-year period have been studied. The pathology was found to be common bile duct (CBD) stone in 22 patients (44%); pancreatic carcinoma in 15 (30%), 3 of whom also had CBD stones; chronic pancreatitis in 4 (8%); extrahepatic CBD carcinoma in 4 (8%); ampulla of Vater carcinoma in 3 (6%); primary duodenal carcinoma in 1 (2%); and portahepatis obstruction in 4 (8%). The 8 postoperative deaths (16%) were found to be associated with high preoperative levels of serum bilirubin, but all occurred in patients with malignant disease. Complications occurred in 20 patients (40%) and bile culture state was found to be intimately related to the morbidity rather than operative mortality. The study represents a careful audit of the pathology distribution and the surgical management of obstructive jaundice as seen in district hospitals.
对在6年期间由一位外科医生（RECC）负责、于坎特伯雷和萨尼特健康区医院接受手术治疗的50例连续性梗阻性黄疸患者进行了研究。结果发现，病理情况为：22例（44%）胆总管结石；15例（30%）胰腺癌，其中3例同时伴有胆总管结石；4例（8%）慢性胰腺炎；4例（8%）肝外胆总管癌；3例（6%） Vater壶腹癌；1例（2%）原发性十二指肠癌；4例（8%）肝门梗阻。8例术后死亡（16%）被发现与术前血清胆红素水平升高有关，但均发生在恶性疾病患者中。20例患者（40%）出现并发症，且胆汁培养结果被发现与发病率密切相关，而非手术死亡率。该研究代表了对地区医院所见梗阻性黄疸的病理分布和手术治疗的仔细审核。
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