Daher M, Yammine G, Nassif K
Service de Chirurgie générale, Hôpital Saint-Georges, Beyrouth, Liban.
J Med Liban. 1993;41(4):206-12.
In a retrospective study of a 10-year period (1982-1991), the results of 672 consecutive operations for cholecystectomy were analyzed. 67.7% were females and the medium age was 54.4%. Ultrasound is used to be the test of choice and surgery was done for chronic cholecystitis in 79.9% and in 20.1% for acute cholecystitis. With an overall mortality rate of 1.9% and a morbidity of 16%, conventional cholecystectomy proved to be a safe method. Mortality and morbidity seem to be related to age (> 60 years, median age 70.5), sex (men = 70%), and associated procedures (choledochotomy with exploration, sphincterotomy, biliary derivation). Systematic antibiotic prophylaxis and non drainage of the sub-hepatic area in certain cases lowered the incidence of wound infection, and improved post-operative course. Selective operative cholangiogram also improved per and post-operative course and does not seem to increase the incidence of residual stones. Now, only the new laparoscopic cholecystectomy may represent the alternative to the ideal treatment of cholecystolithiasis.
在一项为期10年（1982 - 1991年）的回顾性研究中，分析了连续672例胆囊切除术的结果。67.7%为女性，平均年龄为54.4岁。超声检查曾是首选检查方法，79.9%的手术是针对慢性胆囊炎进行的，20.1%是针对急性胆囊炎进行的。传统胆囊切除术的总体死亡率为1.9%，发病率为16%，事实证明这是一种安全的方法。死亡率和发病率似乎与年龄（>60岁，平均年龄70.5岁）、性别（男性占70%）以及相关手术操作（胆总管切开探查、括约肌切开术、胆管引流术）有关。系统性抗生素预防以及在某些情况下不进行肝下区域引流降低了伤口感染的发生率，并改善了术后病程。选择性术中胆管造影也改善了术中和术后病程，且似乎并未增加残余结石的发生率。如今，只有新型腹腔镜胆囊切除术可能成为胆囊结石理想治疗方法的替代选择。
