The diagnosis and treatment of acute gangrenous cholecystitis in senile patients
- VernacularTitle:老年人急性坏疽性胆囊炎的诊断与治疗
- Author:
Li WANG
;
Yun WANG
- Publication Type:Journal Article
- Keywords:
Cholecystitis/surg;
Cholecystectomy;
Cholecystitis,Acute
- From:
Chinese Journal of General Surgery
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the diagnosis and treatment of acute gangrenous cholecystitis in senile (patients), so as to decrease complications and lower the mortality rate. Methods The clinical data of 112 senile patients with acute gangrenous cholecystitis were retrospectived analysed.Results 19 cases(17.0%) of the 112 patients had hyperpyrexia, 8(7.1%) had icterus,11(17.0%) had a mass in the right upper abdomen, 26(23.2%) had symptoms of peritonitis; 11(9.8%) were complicated with acute edematous pancreatitis, 5(4.5%) had acute obstructive suppurative cholangitis, 6(5.4%) had septic shock. All of the 112 patients underwent surgery. At operation, 79 of 95 cases of acute calculous cholecystitis had (gangrene) of gallbladder,16(16.8%) had gangrene with perforation; in 17 cases with acute non-calculous cholecystitis had gangrene of gallbladder, 9(52.9%) had gangrene with perforation. Of the 112 patients, 86 underwent cholecystectomy, 18 underwent partial cholecystectomy, 5 underwent cholecystectomy with bile duct exploration and T tube drainage, and 3 underwent cholecystostomy 104 patients(92.9%) were cured, 8 patients(7.1%) died, and 9(8.7%) of the 104 cured patients had postoperative complications. (Conclusions) Acute gangrenous cholecystitis in senile patients should be definitely diagnosed as soon as (possible), co-existent diseases should be correctly treated, emergency operation should be performed with in 24 hours of onset of symptoms(or in the shortest time after admission), and a suitable operation should be (selected).
