Penkov N, Viiachki I, Iarŭmov N, Vladimirov B, Ivanov A, Kolarov E
Khirurgiia (Sofiia). 1994;47(6):17-21.
After analyzing the summed up treatment results in 368 patients with acute cholecystitis, complicated by obstructive jaundice, the inference is reached that it is a matter of a complication, unfavourable in terms of prognosis, with a definite impact on both immediate and long-term therapeutic results. Early operative intervention following intensive preoperative preparation (including ERHPG with endoscopic papillosphincterotomy and ensuing biliary decompression, or echographic percutaneous cholecystectomy) contribute to control the acute inflammatory process in the gallbladder, and preclude the development of liver (or hepato-renal) failure against the background of obstructive jaundice. Proceeding from the severe, irreversible changes in liver and kidney, hardly responding to treatment, and persisting deterioration of the general condition, acute cholecystitis complicated by obstructive jaundice is defined as an emergency life-endangering condition, requiring a priority operative approach.
在分析了368例并发梗阻性黄疸的急性胆囊炎患者的综合治疗结果后,得出的结论是,这是一种预后不良的并发症,对近期和长期治疗结果均有一定影响。在进行强化术前准备(包括内镜乳头括约肌切开术及随后的胆道减压的内镜逆行胰胆管造影术,或超声引导下经皮胆囊切除术)后尽早进行手术干预,有助于控制胆囊的急性炎症过程,并防止在梗阻性黄疸背景下发生肝(或肝肾)衰竭。鉴于肝脏和肾脏出现严重的、不可逆的变化,对治疗反应不佳,且全身状况持续恶化,并发梗阻性黄疸的急性胆囊炎被定义为危及生命的紧急情况,需要优先采取手术治疗方法。