Carroll B J, Rosenthal R J, Phillips E H, Bonet H
Division of Minimally Invasive Surgery, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA.
Surg Endosc. 1995 Aug;9(8):874-8. doi: 10.1007/BF00768881.
We retrospectively evaluated the results of laparoscopic cholecystectomy in patients infected with the human immunodeficiency virus (HIV) with and without acquired immunodeficiency syndrome (AIDS). One thousand one hundred twenty-seven consecutive patients underwent laparoscopic cholecystectomy by our surgical group. Eighteen of these patients were known to be infected with the HIV virus; 6 were asymptomatic and 12 had AIDS. We reviewed the medical records of all HIV-positive individuals with regard to morbidity, mortality, and postoperative outcome following laparoscopic cholecystectomy. In the six HIV-patients without AIDS, five (83%) had improvement of symptoms postoperatively. There was one minor complication (17%). In contrast, only one of the 12 patients with AIDS had postoperative improvement of symptoms and eight (66%) had complications after surgery. There were four deaths (33%) within 30 days of surgery in this group. Only a small percentage of AIDS patients benefit from laparoscopic cholecystectomy. There is a significantly morbidity and mortality following this procedure in this group. Strategies to improve outcome are presented.
我们回顾性评估了感染人类免疫缺陷病毒(HIV)且有无获得性免疫缺陷综合征(AIDS)的患者行腹腔镜胆囊切除术的结果。我们的手术团队连续为1127例患者实施了腹腔镜胆囊切除术。其中18例患者已知感染HIV病毒;6例无症状,12例患有AIDS。我们查阅了所有HIV阳性患者腹腔镜胆囊切除术后的发病率、死亡率及术后转归的医疗记录。在6例无AIDS的HIV患者中,5例(83%)术后症状改善。有1例轻微并发症(17%)。相比之下,12例AIDS患者中只有1例术后症状改善,8例(66%)术后出现并发症。该组在术后30天内有4例死亡(33%)。只有一小部分AIDS患者能从腹腔镜胆囊切除术中获益。该组患者行此手术后有显著的发病率和死亡率。本文提出了改善治疗效果的策略。