<総説>術後急性胆嚢炎 : 本邦182例(自験7例を含む)についての考察

概要

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Although the frequency is rare, postoperative acute cholecystitis is one of the hazardous problems on elderly patients in the postoperative periods. This cholecystitis is usually acalculous and develops rapid necrosis of the gallbladder wall, which easily results in fatal outcome. In the review of Japanese literature including seven of our cases, the characteristics of this cholecystitis were demonstrated ; the majority of male patients, marked distribution of patients of 60 years or older, high frequency of cancer of the stomach as an original disease and of total gastrectomy as an initial operation, and high mortality. Early and delayed onsets following the initial surgery were noted, the former type of cholecystitis occurred within one month. The ratio of the early to the delayed was 4.7 : 1. The inducing factors of this cholecystitis are considered to be multiple ; concentrated bile, first food-intake after postoperative fasting, effects of vagotomy, general hypoperfusion, and so on. Several simultaneous multi-factors may be responsible for the occurrence of this cholecystitis. If a patient in a postoperative period complained of the symptoms simulating cholecystitis, ultrasonographic examination of the abdomen should be performed at first to rule out other diseases, and early cholecystectomy is recommended to improve the prognosis whenever the presence of cholecystitis is demonstrated.
近畿大学の論文
1984-03-25