Aulagnier G, Fournier B, Donné R, Guillet R
J Chir (Paris). 1980 Jun-Jul;117(6-7):393-5.
Two recent cases of acute cholecystitis without gallstones following gastrectomy are reported. Details of the cases are described and the rare nature of this postoperative complication emphasized. Clinical diagnosis is difficult and the cause of this complication is usually not ascertained. Cholecystectomy remain the basic treatment, of choice, but cholecystotomy or simple drainage may be the only possible therapy, and should be employed whenever necessary. Postoperative acute cholecystitis is rarely observed, is usually associated with gallstones, and occurs in patients with previously healthy gallbladders in only exceptional cases, usually following digestive tract operations (Thomoret and Bronstein, 9). The initial surgical intervention then involves the stomach, whether it be a gastrectomy or vagotomy (Champeau, Delattre, 2). Two recent cases of post-gastrectomy acute cholecystitis without gallstones led to a review of the published literature to determine the frequency of this complication, and an attempt to define its characteristics.
本文报告了两例胃切除术后发生的无胆结石性急性胆囊炎病例。文中描述了病例细节,并强调了这种术后并发症的罕见性。临床诊断困难,该并发症的病因通常难以确定。胆囊切除术仍是首选的基本治疗方法,但胆囊切开术或单纯引流可能是唯一可行的治疗方法,必要时应采用。术后急性胆囊炎很少见,通常与胆结石有关,仅在极少数情况下发生于胆囊先前健康的患者,通常是在消化道手术后(托莫雷和布朗斯坦,9)。最初的外科手术干预涉及胃部,无论是胃切除术还是迷走神经切断术(尚波、德拉特尔,2)。最近两例胃切除术后无胆结石性急性胆囊炎病例促使我们回顾已发表的文献,以确定这种并发症的发生率,并试图明确其特征。