Nozoe T, Kitamura M, Matsumata T, Nakamoto M, Goya T, Sugimachi K
Department of Surgery, Saiseikai Yahata General Hospital, Kitakyushu, Japan.
Int Surg. 1998 Apr-Jun;83(2):115-8.
Incidences of the variety of postoperative complications in surgical treatment for patients with chronic renal failure on hemodialysis is the clinically accepted opinion. The aim of this study was to ascertain the safety of surgical treatment for patients of biliary lithiasis with chronic renal failure on hemodialysis.
Eleven consecutive patients with biliary lithiasis, who had a history of chronic renal failure treated with hemodialysis, were selected. The peri-operative course in-each of these cases was investigated.
There was no incidence of peri-operative problems and postoperative complications in cases treated with laparoscopic cholecystectomy. One case treated with cholecystectomy with laparotomy had a slight degree of postoperative pneumonia, which soon improved after administration of antibiotics. Only one case, treated with choledochotomy, resulted in operative death due to accidental septic shock from an unknown origin.
Surgical treatment of patients with biliary lithiasis and chronic renal failure on hemodialysis can be safely performed with appropriate operative indications and noninvasive surgical techniques.
慢性肾衰竭患者接受血液透析时，外科手术治疗后各种术后并发症的发生率是临床公认的观点。本研究的目的是确定接受血液透析的慢性肾衰竭合并胆石症患者手术治疗的安全性。
选取11例有慢性肾衰竭血液透析病史的连续胆石症患者。对每例患者的围手术期过程进行调查。
接受腹腔镜胆囊切除术的病例未发生围手术期问题和术后并发症。1例行开腹胆囊切除术的患者术后有轻度肺炎，使用抗生素后很快好转。仅1例行胆总管切开术的患者因不明原因的意外感染性休克导致手术死亡。
对于接受血液透析的慢性肾衰竭合并胆石症患者，在有适当的手术指征和采用无创手术技术的情况下，可以安全地进行手术治疗。
