Management of Acute Cholecystitis

Wr, Meeker

doi:10.1097/00007611-197207000-00006

Southern Medical Journal

1972

DOI: 10.1097/00007611-197207000-00006

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Management of Acute Cholecystitis

Meeker Wr¹

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1976

1981

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“…There is no agreement on this opinion; some [7] maintain that iatrogenic lesions are more frequent in urgent operations, and others [8,9] believe that they are more frequent in operations carried out some months after the beginning of the acute phase. Strictures observed after uncomplicated choledochotomies where, apparently, the only information is that a normal and correct operative procedure was performed could be added to these local factors.…”

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Iatrogenic strictures of the bile ducts: Our experience with 66 cases

Castrini

Pappalardo

1981

World j. surg.

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The authors report their experience with 66 patients operated on for iatrogenic strictures of the bile ducts. Among the factors that are considered to predispose to or to cause iatrogenic strictures, all of which have been accurately analyzed, urgent operations for acute cholecystitis have particular importance. The percutaneous transhepatic and duodenoscopic retrograde cholangiographies represent a complementary means for a precise diagnosis of the stricture. Treatment consists of a Roux‐en‐Y hepaticojejunostomy, but in recent years, a biliary‐duodenal interposition utilizing a defunctionalized jejunal limb was preferred. Postoperative morbidity was 22.7%, mortality 3%. Consideration is given to the technique of anastomosis and to the use of transanastomotic drainage. Finally, the results of follow‐up with particular reference to the treatment of strictures of the hepaticojejunostomy, with an incidence of 15.4% in this series of patients, have been analyzed.

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confidence: 99%

Iatrogenic strictures of the bile ducts: Our experience with 66 cases

Castrini

Pappalardo

1981

World j. surg.

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Treatment of cholecystitis: Cholecystostomy or cholecystectomy?

Vuori¹

1976

The American Journal of Surgery

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Acute Cholecystitis Treated by Early and Delayed Surgery. A Controlled Clinical Trial

Lahtinen

Alhava

Aukee

1978

Scandinavian Journal of Gastroenterology

131

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100 patients with acute cholecystitis (AC) diagnosed by clinical, laboratory, and roentgenological examinations were randomly divided into 2 groups; early surgery (ES), operated within 7 days after the onset of acute symptoms, and delayed (DS), operated 2--3 months after the acute episode. Patients with elevated serum bilirubin and/or amylase were included in the trial. Two patients died during conservative treatment, and in 4 cases medical treatment was interrupted because of peritonitis, and in 3 cases because of increasing jaundice. Recurrence of AC was found in 24% of the patients in the DS group. There was no mortality in the ES group, but 2 patients died postoperatively in the DS group. Wound infection developed in 3 patients in the ES, and in 8 patients in the DS group. Retained stones remained in 3 cases of the DS and in 1 case of the ES group. The operative procedures were easier to perform in the ES group than in the DS, as estimated by the duration of operation. The operation time was 76.7 +/- 4.6 min (mean p S.E.) in the ES and 98.0 +/- 7.3 min in the DS group. There was a statistically significant difference between the 2 groups (p less than 0.01). The results suggest that early surgery in the treatment of acute cholecystitis is recommended. The complications of failed medical treatment can be avoided by early operation without added risk of mortality or complications.

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Management of Acute Cholecystitis

Cited by 3 publications

References 0 publications

Iatrogenic strictures of the bile ducts: Our experience with 66 cases

Iatrogenic strictures of the bile ducts: Our experience with 66 cases

Treatment of cholecystitis: Cholecystostomy or cholecystectomy?

Acute Cholecystitis Treated by Early and Delayed Surgery. A Controlled Clinical Trial

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