Bülow S, Kronborg O, Lund-Kristensen J
Arch Surg. 1977 Mar;112(3):282-4. doi: 10.1001/archsurg.1977.01370030054009.
Ninety-two patients with suppurative cholecystitis operated on as emergency cases were studied in retrospection. Obstructive cholangitis was seen in two, who eventually died. The mortality after cholecystectomy alone was related to the presence of stones in the common bile duct. The mortality after cholecystostomy alone was related to shock and septicemia, but not to the presence of common bile duct stones or obstructive cholangitis. It was concluded that suppurative cholecystitis with accompanying common bile duct stones should be treated with cholecystectomy and choledocholithotomy, because of the lower rate of reoperations and possibly lower mortality than after cholecystectomy alone; an exception should be made in patients with deterioration in clinical condition or patients in whom technical difficulties develop during the operation. These patients should be subjected to a cholecystostomy as the only emergency procedure.
对92例作为急诊病例接受手术治疗的化脓性胆囊炎患者进行了回顾性研究。其中2例出现梗阻性胆管炎，最终死亡。单纯胆囊切除术后的死亡率与胆总管结石的存在有关。单纯胆囊造口术后的死亡率与休克和败血症有关，但与胆总管结石或梗阻性胆管炎的存在无关。得出的结论是，伴有胆总管结石的化脓性胆囊炎应行胆囊切除术和胆总管切开取石术，因为与单纯胆囊切除术后相比，再次手术率较低，死亡率可能也较低；临床状况恶化的患者或手术过程中出现技术困难的患者除外。这些患者应仅接受胆囊造口术作为紧急手术。
