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Feasibility and problem in managements of the patients with acute cholecystitis: A historical study at a single province institute.


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タイトル: Feasibility and problem in managements of the patients with acute cholecystitis: A historical study at a single province institute.
著者: Yamanouchi, Kosho / Azuma, Takashi / Taniguchi, Ken / Inoue, Yusuke / Handa, Keisuke / Matsuo, Shigetoshi
発行日: 2012年 1月
出版者: Nagasaki University School of Medicine / 長崎大学医学部
引用: Acta Medica Nagasakiensia, 56(3), pp.69-72; 2012
抄録: Objectives: "Practice Guidelines for Acute Cholecystitis and Acute Cholangitis (in Japanese)," issued in 2005 in Japan, recommends early cholecystectomy in patients with acute cholecystitis. We evaluated the feasibility and problems in management of this condition. Method: We analyzed the clinical and laboratory data of 120 consecutive patients in whom cholecystectomy was performed for treatment of acute cholecystitis between April 2003 and March 2010 in our hospital. Results: After the Guidelines were issued, the rate of urgent operations increased (from 2.4% to 35.4%; p < 0.001) and the length of preoperative hospital stay decreased (form 12.5 days to 7.6 days; p < 0.05). Urgent operation, however, was chosen in only 35.4% of the patients even after the Guidelines were issued, mainly because of the shortage of surgeons and anesthesiologists. In these patients with moderate to severe acute cholecystitis, percutaneous cholecystostomy (PC) was performed without severe complications, followed by cholecystectomy. Conclusion: Urgent operation for acute cholecystitis has the advantages of earlier alleviation of symptoms and shorter hospital stays than PC followed by surgery or elective operation. PC followed by surgery may be a suboptimal option for patients with moderate to severe acute cholecystitis who might be able to tolerate an urgent operation, given that appropriate human resources are not available.
キーワード: acute cholecystitis / cholecystectomy / drainag
URI: http://hdl.handle.net/10069/27501
ISSN: 00016055
資料タイプ: Departmental Bulletin Paper
原稿種類: publisher
出現コレクション:Volume 56, No. 3

引用URI : http://hdl.handle.net/10069/27501

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