Schramm H
Chirurgische Klinik I, Akademisches Lehrkrankenhaus, Friedrich-Schiller-Universität Jena.
Zentralbl Chir. 1998;123 Suppl 2:70-3.
The over notion, "acute gallbladder" includes the acute cholecystitis, also the gallbladder dropsy, the persistent colicky pain of the impaction, the complications of acute cholecystitis like the cholecystoempyema an necrotising the calculous impaction inflammation. In the last cases an emergency operation ist necessary. The acute cholecystitis and also the acute gallbladder dropsy have to be operated in an unit of time of 72 hours. By this patients the capability of operation and narcosis is a prerequisite. The late operation also the interval operation are united with greater operative technical difficulties an the danger of intraoperative complications. The indication for the cholecystostomy ist rare. Is an anaesthesia not possible a surgical stomy in local anaesthesia or a percutaneous transhepatic puncture drainage with sonography and CT-control ist possible. There are scarcely contra-indications for the laparoscopy.
总体而言，“急性胆囊炎”包括急性胆囊炎，还有胆囊积水、结石嵌顿引起的持续性绞痛、急性胆囊炎的并发症如胆囊积脓和坏死性结石嵌顿性炎症。在最后这些情况下，必须进行急诊手术。急性胆囊炎和急性胆囊积水必须在72小时内进行手术。对于这些患者，手术能力和麻醉是前提条件。晚期手术以及间隔手术会伴随着更大的手术技术难度和术中并发症风险。胆囊造口术的指征很少见。如果无法进行麻醉，可以在局部麻醉下进行外科造口术，或者在超声和CT引导下进行经皮经肝穿刺引流。腹腔镜检查几乎没有禁忌证。
