Kiekens R, Van Geertruyden J, Ansay J, Arianoff A A, Chastel C, De Groof E, Demol J, Deschreyer M, Flamme A, Goldschmidt D, Huyghe J, Lantin F, Lavigne J C, Mendes da Costa P, Noorbergen M, Van Loon C
Acta Chir Belg. 1983;Suppl:29-34.
In 17 Belgian surgical centers, 324 operations have been performed for acute cholecystitis in patients 80 years of age or older. In this group of patients: 1. The incidence of acute cholecystitis is hardly higher in women than in men. 2. The patients were operated within 24 hours of admission in 38% of cases. The main bile duct was surgically explored in 1/3 of patients. Cholecystostomy or simple drainage were used in 1/10 of cases only. 3. Operative mortality was 19%. It was higher for patients operated as emergencies than for delayed operations and higher also when the cholecystectomy was associated with an exploration of the bile duct. The ideal treatment for such patients should thus be a cholecystectomy with an endoscopic sphincterotomy.
在17家比利时外科中心,已对80岁及以上的患者进行了324例急性胆囊炎手术。在这组患者中:1. 急性胆囊炎的发病率在女性中几乎不比男性高。2. 38%的病例在入院后24小时内进行了手术。三分之一的患者接受了胆管手术探查。仅十分之一的病例采用了胆囊造口术或单纯引流术。3. 手术死亡率为19%。急诊手术患者的死亡率高于延期手术患者,当胆囊切除术与胆管探查同时进行时死亡率也更高。因此,对此类患者的理想治疗方法应是胆囊切除术加内镜括约肌切开术。