Dumont A E
Surg Gynecol Obstet. 1976 Jun;142(6):855-7.
The incidence and significant of hyperbilirubinemia were examined in 110 consecutive patients who entered the hospital with signs and symptoms of acute cholecystitis and underwent laparotomy. Thirty-two or 29 per cent were found to have abnormally elevated serum bilirubin levels on admission. Surgical or roentgenographic examination of the common duct, or both, in 19 of these patients disclosed stones in 13. Serum levels of bilirubin averaged 6.1 milligrams per cent in those with stones and 2.7 milligrams per cent in the others. In the remaining 13 patients, the common duct was not examined, but elevated bilirubin levels, averaging 2.6 milligrams per cent, quickly returned to normal values, and the subsequent course was uneventful. Hyperbilirubinemia significantly increases the likelihood of finding common duct stones in patients with acute cholecystitis, although it also occurs frequently in patients with acute cholecystitis without common duct stones. The underlying mechanism in the latter situation is still oscure but may depend on an alteration in the normal impermeability of epithelium of the gallbladder to conjugated bilirubin.
对110例因急性胆囊炎症状和体征入院并接受剖腹手术的连续患者进行了高胆红素血症的发生率及意义研究。发现32例（29%）患者入院时血清胆红素水平异常升高。对其中19例患者进行胆总管的手术或X线检查，或两者皆做，发现13例有结石。有结石患者的血清胆红素水平平均为6.1毫克%，其他患者为2.7毫克%。其余13例患者未检查胆总管，但胆红素水平升高，平均为2.6毫克%，随后迅速恢复正常，后续病程平稳。高胆红素血症显著增加了急性胆囊炎患者发现胆总管结石的可能性，尽管在无胆总管结石的急性胆囊炎患者中也经常出现。后一种情况下的潜在机制仍不清楚，但可能取决于胆囊上皮对结合胆红素正常通透性的改变。
