Pezzolla F, Lorusso D, Guerra V, Giorgio I
Scientific Institute for Digestive Diseases S. de Bellis, Department of Surgery, Castellana Grotte (Bari), Italy.
Acta Chir Belg. 1993 Jul-Aug;93(4):154-7.
Twenty-three patients who underwent elective surgery for colorectal cancer in our hospital between 1983 and 1989, underwent concomitant cholecystectomy for asymptomatic gallstones. In order to assess whether additional cholecystectomy increases postoperative morbidity and mortality, a comparison was made between these cases and 23 controlled patients (without gallstones) matched for sex, age (+/- 3 years), Dukes stage and type of primary colonic surgery. The duration of postoperative stay was similar in the two groups (14.1 +/- 4.5 days vs 12.4 +/- 2.3 days). Postoperative complications were more frequent among the case patients than among the controls (34.8% vs 8.7%, p = 0.04), and the same was true for the mortality (8.7% vs 0%). During the same period, another 11 patients with asymptomatic cholelithiasis were operated on for colorectal cancer but in these patients gallstones were left in place. Two of the patients died postoperatively and only one of the remaining 9 (11.2%) had an episode of biliary pain. The results of our study would suggest that in patients undergoing surgery for colorectal cancer the risk entailed in carrying out an additional cholecystectomy for asymptomatic gallstones is greater than the risk of future morbidity caused by gallstones left in place.
1983年至1989年间，我院23例接受择期结直肠癌手术的患者同时接受了无症状胆结石的胆囊切除术。为了评估额外的胆囊切除术是否会增加术后发病率和死亡率，将这些病例与23例对照患者（无胆结石）进行了比较，对照患者在性别、年龄（±3岁）、Dukes分期和原发性结肠手术类型方面相匹配。两组术后住院时间相似（14.1±4.5天对12.4±2.3天）。病例组患者术后并发症比对照组更常见（34.8%对8.7%，p = 0.04），死亡率情况相同（8.7%对0%）。在同一时期，另有11例患有无症状胆石症的患者接受了结直肠癌手术，但这些患者的胆结石未予处理。其中2例患者术后死亡，其余9例中只有1例（11.2%）出现胆绞痛发作。我们的研究结果表明，对于接受结直肠癌手术的患者，因无症状胆结石而进行额外胆囊切除术所带来的风险大于保留胆结石所导致的未来发病风险。
