Apsatarov E A, Belozerova T P
Vestn Khir Im I I Grek. 1978 Aug;121(8):49-51.
To ground the surgical technic and pathognomic postoperative management some etiopathogenetic problems of acute cholecystitis have been studied. The gallbladder contents and abdominal cavity exudate and their effect upon the amylase activity and microflora have been analyzed. The analysis has shown that in the pathogenesis of acute cholecystitis in elderly and senile patients the fermentative component plays an important part, which results in a rapid destruction of the gallbladder against the background of vascular disorders. Such cases need an earlier decompression of the biliary tract and the postoperative management should be aimed at the suppression of pancreatic secretion. As to the majority of the cases of acute cholecystitis, which not infrequently possesses some features of a longlasting chronic process, the operation should be postponed till inflammatory manifestations subside.
为了夯实手术技术和典型的术后管理，对急性胆囊炎的一些病因发病学问题进行了研究。分析了胆囊内容物和腹腔渗出液及其对淀粉酶活性和微生物群的影响。分析表明，在老年和高龄患者急性胆囊炎的发病机制中，发酵成分起重要作用，这导致在血管紊乱的背景下胆囊迅速破坏。此类病例需要早期胆道减压，术后管理应旨在抑制胰腺分泌。至于大多数急性胆囊炎病例，其常常具有一些长期慢性病程的特征，手术应推迟至炎症表现消退。
