Abstract
Postoperative acute cholecystitis following surgery unrelated to the biliary tract is a rare complication. Of 49 cases of this disease collected from the Japanese literature, including 3 of our cases, the ratio of males to females was 42∶7, the ages ranged from 31 to 83 years, and 82% of the patients had no biliary calculi. The antecedent operation was performed for cancer of the stomach in 30 patients (61%), and for another type of cancer in an additional 10. Several pathogenetic factors that differ from those responsible for ordinary cholecystitis are considered to be contributory to this disease, among which impairment of the circulation to the gallbladder may be one of the most important. The overall mortality rate of postoperative cholecystitis was 32%. Although cholecystectomy is the preferred treatment, local findings or the condition of the patient should be considered in the decision regarding therapy. Early surgical intervention should not be delayed in the elderly patient, because there was a significant difference between the average age of survivors and those who died.
Résumé
La cholécystite aiguë postopératoire est une complication rare des opérations ne portant pas sur l'arbre biliaire. Nous avons revu 49 cas publiés dans la littérature japonaise, y compris 3 cas personnels. La proportion hommes/femmes est de 42/ 7. L'âge va de 31 à 83 ans. Il n'y avait pas de lithiase dans 82% des cas. L'opération déclenchante avait été faite pour cancer de l'estomac dans 30 cas (61%) et pour un autre cancer dans 10 cas. Plusieurs facteurs pathogènes, inexistants dans la cholécystite classique, jouent un rôle: les altérations circulatoires vésiculaires sont probablement le plus important. La mortalité globale est de 32%. La cholécystectomie est le meilleur traitement; mais la décision thérapeutique doit dépendre de l'état du malade et des conditions locales. L'intervention doit être précoce surtout chez les malades âgés: il y a une différence d'âge significative entre les survivants et les décès.
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Kasahara, Y., Umemura, H., Kuyama, T. et al. Postoperative acute cholecystitis in Japan. World J. Surg. 2, 661–665 (1978). https://doi.org/10.1007/BF01556073
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DOI: https://doi.org/10.1007/BF01556073