典型文献
Gallbladder perforation:A single-center experience in north India and a step-up approach for management
文献摘要：
Background:Spontaneous gallbladder perforation(GBP)is an uncommon diagnosis.This study presented the experience of managing spontaneous GBP over nine years at a large,tertiary care university hospital in north India and investigated the outcomes and treatment strategies.Methods:A retrospective review of prospectively maintained digital database of consecutive patients was performed.All patients received medical and/or surgical treatment for spontaneous GBP in our depart-ment between January 2010 and June 2018.Results:We identified 151 patients(81 females and 70 males)with mean age of 53 years.Most common presenting features were pain(96.7％),fever(54.3％)and jaundice(31.1％).Most common cause was gall-bladder stones(84.8％)followed by common bile duct stones(30.5％),xanthogranulomatous cholecystitis(17.9％)and malignancy(11.9％).As per Niemeier classification,8.6％had type 1 GBP(free perforation in peritoneal cavity),76.2％had type 2 GBP(localized perforation)and 13.2％had type 3 GBP(cholecysto-enteric fistula).About 60％of the perforations were diagnosed preoperatively.Type 1 was more com-mon in patients with diabetes and also had the worst prognosis.Surgery was performed in 109 patients(72.2％).Seven patients(4.6％)had a postoperative morbidity of Clavien-Dindo Ⅲ or higher.There were three mortalities in patients who underwent surgery.Conclusions:High index of suspicion is required for preoperative diagnosis of GBP,especially in types 2 and 3.Laparoscopic cholecystectomy can be difficult in these patients and patients may require open or partial cholecystectomy.Early diagnosis and step-up approach for the treatment of GBP is critical.
文献关键词：
中图分类号：
作者姓名：
Vivek Gupta;Abhijit Chandra;Vishal Gupta;Ravi Patel;Amit Dangi;Ajay Pai
作者机构：
Department of Surgical Gastroenterology,King George's Medical University,Lucknow,Uttar Pradesh 226003,India
文献出处：
引用格式：
[1]Vivek Gupta;Abhijit Chandra;Vishal Gupta;Ravi Patel;Amit Dangi;Ajay Pai-.Gallbladder perforation:A single-center experience in north India and a step-up approach for management)[J].国际肝胆胰疾病杂志(英文版),2022(02):168-174
A类：
xanthogranulomatous,Niemeier,cholecysto,perforations
B类：
Gallbladder,single,center,experience,north,India,step,up,approach,management,Background,Spontaneous,gallbladder,GBP,uncommon,diagnosis,This,study,presented,managing,spontaneous,over,nine,years,large,tertiary,care,university,hospital,investigated,outcomes,treatment,strategies,Methods,retrospective,review,prospectively,maintained,digital,database,consecutive,patients,was,performed,All,received,medical,surgical,our,depart,between,January,June,Results,We,identified,females,mean,Most,presenting,features,were,pain,fever,jaundice,cause,stones,followed,by,bile,duct,cholecystitis,malignancy,classification,had,free,peritoneal,cavity,localized,enteric,fistula,About,diagnosed,preoperatively,Type,more,diabetes,also,worst,prognosis,Surgery,Seven,postoperative,morbidity,Clavien,Dindo,higher,There,three,mortalities,who,underwent,surgery,Conclusions,High,suspicion,required,especially,types,Laparoscopic,cholecystectomy,can,difficult,these,may,open,partial,Early,critical
AB值：
0.560362
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