Dalmas H, Picaud R, Anfossi G, Giudicelli C
J Chir (Paris). 1979 Mar;116(3):193-200.
The authors studied 333 acute cholecystitis out of 2,200 operated on for lithiasis of the gall-bladder, 186 bacteriological tests were carried out on the vesicular liquid and wall. They insist on the main anatomo-pathological characteristic: early, partial or total destruction of the mucous together with acute inflammatory lesions of the wall and even sometimes necrosis. This irreversible lesion is due to the acute obstruction of the gall-bladder by blockage of a calculus. Acute cholecystitis are practically always aseptic at the beginning. Sepsis is a secondary complication. These anatomo-pathological and bacteriological elements have two therapeutic corollaries: 1. The patient has to be operated very early at the aseptic stage. 2. Preliminary antibiotherapy becomes useless. Under these conditions there is practically no death before the age of 65. Mortality concern old people, operated late and suffering from other disease.
作者对2200例因胆囊结石接受手术治疗的患者中的333例急性胆囊炎患者进行了研究，对囊液和胆囊壁进行了186次细菌学检测。他们强调主要的解剖病理学特征：黏膜早期、部分或全部破坏，同时伴有胆囊壁的急性炎症病变，甚至有时出现坏死。这种不可逆的病变是由于结石阻塞导致胆囊急性梗阻所致。急性胆囊炎在开始时几乎总是无菌的。脓毒症是一种继发性并发症。这些解剖病理学和细菌学因素有两个治疗推论：1. 患者必须在无菌阶段尽早接受手术。2. 预防性抗生素治疗变得无用。在这些情况下，65岁之前实际上没有死亡病例。死亡病例多为老年人，手术较晚且患有其他疾病。
