Zuccarini F, Bottegoni G, Leombruni E, Filippini A, Bastonno O, Costantini D, Picardi N
I Divisione di Chirurgia, Università degli Studi, G. D'Annunzio di Chieti.
Ann Ital Chir. 1995 Sep-Oct;66(5):665-9.
Postoperative infections are one of the most frequent causes of morbidity in surgical patients. In biliary tract surgery the risk of septic complications is essentially increased by opening the bile ducts. Aim of this paper is to evaluate indications and effectiveness of short-term prophylaxis in preventing infective complications of biliary surgery. Authors report a personal six years review regarding 530 patients operated for biliary tract diseases. The patients were divided into two groups: the first one (n. 245) operated under short-term prophylaxis; the second one (n. 285) treated only postoperativelly with antibiotics. The results obtained show a significatively higher rate of infective complications in the second group of patients. There is a little difference between the groups in the case of elective cholecystectomy, whereas there is a great difference in case of non-elective surgery, bile ducts opening, external biliary drainages placement or sphincteropapillotomy. Authors furthermore emphasize how surgical results are conditioned by individual risk factors, especially obesity and diabetes.
术后感染是外科手术患者发病的最常见原因之一。在胆道手术中,打开胆管会显著增加脓毒症并发症的风险。本文旨在评估短期预防措施在预防胆道手术感染性并发症方面的适应证和有效性。作者报告了对530例接受胆道疾病手术患者的个人六年回顾。患者分为两组:第一组(245例)接受短期预防治疗;第二组(285例)仅在术后使用抗生素治疗。获得的结果显示,第二组患者的感染性并发症发生率显著更高。在择期胆囊切除术的情况下,两组之间差异不大,而在非择期手术、胆管开口、放置外部胆道引流管或乳头括约肌切开术的情况下,差异很大。作者还强调,手术结果受个体风险因素的影响,尤其是肥胖和糖尿病。