This report is consisted of a review of 120 cases of acute cholecystitis which is confirmed histopathologically during past 8 years, from June 1968 to May 1976, at the department of General Surgery of Sacred Heart Hospital, Chung-Ang University, School of Medicine. The _results obtained as follow;
1) The incidence of acute cholecystitis was 34,4% of the whole binary surgery and 47.4% of the cholecystitis,
2) The sex ratio was 1 male ´to 1 female and the peak incidence was .4th decade (34.2%), Among this group, 40.9% of patients had onset of disease within 3 days.
3) The prominent symptoms and signs were pain in RUQ(83.3%) and tenderness in RUQ ´(80.3%): Fever Civet 38 degree-C.(23.:4%), but no fever(50.8%).
4) In-laboratory data, leukocytosis(over 10, 000/cm3) was noted in 51.7% of whole cases. Increased total bilirubin(over 2 mg%) was noted in 40.4% of 116 cases and increased alkaline phosphatase(over5 BL unit) in 38.3%.
5)´50%- of whole cases were performed early operation within 48 hours after admission. Of this series, 32. 5% were treated with ´cholecystectomy, 55.0% by cholecystectomy and .choledochostomy, and 12..5% by cholecystectomy, choledochostomy and other procedures.
6) The stones ,were recovered from the gall bladder at operation in 40% of this series and =from the common bile duct in 13.3%.
7) Positive etiologic findings were in 93.6% of patients(53.3%) with previous history :biliary colic,, and were in 70% of patients(41. 6%) without previous history.
-8) Hospitalization was prolonged On the average 7 days in patients undergoing choledo-.chotomy.
9) Possible etiologic factors were stone(77.5%), Ascaris(5.0%) and Clonorchis(1.4%).
10) Bile from 54 out of 78patients showed bacterial growth Bile from 41 out of 54 patients
grew a single species and E. coli was present in 66.6% and Staphylococcus´albus in 20.3%.
11) Postoperative complications(19 cases) were as follow; bileleakage(7 cases), pulmonary
. telectasis(3 cases), septic shock(2 cases) etc.
12) The postoperative mortality rate was 0.7%.
|