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[472例急性胆囊炎手术的年龄分析]

[Analysis by age of 472 acute cholecystitis operations].

作者信息

Arianoff V A, Arianoff A A

出版信息

Acta Chir Belg. 1985 Sep-Oct;85(5):279-85.

PMID:4082848
Abstract

A series of 472 operations of acute cholecystitis has been divided according to 3 age groups: above 80 years, between 70 and 79 years and less than 70 years old. These groups contain respectively 29, 88 and 355 cases. The clinical and pathological forms of these acute cholecystitis, the frequency of occurrence of lithiasis of the main biliary duct (BD) and of accompanying papillary stenosis, the type of surgical treatment, the time of surgery, the mortality and its causes have been comparatively analysed. In the very acute forms, the frequency of association with BD lithiasis, and cancer of the gallbladder increase with age. As could also be expected, an increase of mortality can be noted. Even though it is difficult to establish the least injurious technique to be applied in case of a BD lithiasis, it can be pointed out that the mortality is higher in delayed operations than in emergency operations. For elderly persons with a biliary lithiasis, even asymptomatic operation must be recommended as soon as possible as the frequency of acute cholecystitis as well as mortality increases with age. In acute cholecystitis an emergency operation (24 to 72 hours after admission) will nearly always be necessary.

摘要

472例急性胆囊炎手术病例按3个年龄组划分:80岁以上、70至79岁、70岁以下。这3组分别有29例、88例和355例。对这些急性胆囊炎的临床和病理形式、主胆管结石及伴发乳头狭窄的发生率、手术治疗方式、手术时间、死亡率及其原因进行了比较分析。在极急性形式中,伴发胆管结石和胆囊癌的频率随年龄增加。同样可以预料的是,死亡率也会增加。尽管很难确定在胆管结石病例中应用伤害最小的技术,但可以指出,延期手术的死亡率高于急诊手术。对于患有胆石症的老年人,由于急性胆囊炎的发生率和死亡率均随年龄增加,即使无症状也必须尽早建议手术。在急性胆囊炎中,几乎总是需要进行急诊手术(入院后24至72小时)。

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