Girard R M, Morin M
Department of Surgery, Université de Montréal, PQ.
Can J Surg. 1993 Feb;36(1):75-80.
In a retrospective study of 10,471 cholecystectomies, performed between 1971 and 1990, the incidence and causes of death and morbidity of cholecystectomy were analysed. There were 47 postoperative deaths (0.4%); 6 deaths occurred in 5841 patients less than 50 years old, 23 in 3898 patients between 50 and 70 years old and 18 in 732 patients more than 70 years old. Death rates in each group were, respectively, 0.1%, 0.6% and 2.5% (p < 0.001). The death rate in 9339 patients who had cholecystectomy alone was 0.3% and the death rate in 1132 patients who had a concomitant common bile duct exploration (CBDE) was 1.6% (p < 0.001). Cardiovascular complications were the main cause of death, and biliary, pulmonary and wound complications were the most common. There were 614 complications in 529 patients; 176 of these patients were less than 50 years old, 252 were between 50 and 70 years old and 101 were more than 70 years old. Complication rates were, respectively, 3.0%, 6.5% and 13.8% (p < 0.001). For patients with cholecystectomy alone the morbidity was 3.6% and for patients who had a concomitant CBDE the morbidity was 17% (p < 0.001). The mortality and morbidity of cholecystectomy increase significantly with age and a concomitant CBDE. However, patients who underwent cholecystectomy electively or for acute cholecystitis had comparable mortality and morbidity.
在一项对1971年至1990年间进行的10471例胆囊切除术的回顾性研究中，分析了胆囊切除术的死亡率、发病率及其原因。术后死亡47例（0.4%）；5841例年龄小于50岁的患者中有6例死亡，3898例年龄在50至70岁之间的患者中有23例死亡，732例年龄大于70岁的患者中有18例死亡。每组的死亡率分别为0.1%、0.6%和2.5%（p<0.001）。单纯行胆囊切除术的9339例患者的死亡率为0.3%，同期行胆总管探查术（CBDE）的1132例患者的死亡率为1.6%（p<0.001）。心血管并发症是主要死因，而胆道、肺部和伤口并发症最为常见。529例患者出现614例并发症；其中176例患者年龄小于50岁，252例年龄在50至70岁之间，101例年龄大于70岁。并发症发生率分别为3.0%、6.5%和13.8%（p<0.001）。单纯行胆囊切除术的患者发病率为3.6%，同期行CBDE的患者发病率为17%（p<0.001）。胆囊切除术的死亡率和发病率随年龄增长及同期行CBDE而显著增加。然而，择期行胆囊切除术或因急性胆囊炎行胆囊切除术的患者，其死亡率和发病率相当。
