Showing papers by "Tadahiro Takada published in 1987"

Studies on the surgical selection for acute cholecystitis with clinical course and ultrasonographic findings

Abstract: It has been debated whether eraly or delayed operation should be selected for surgical management of acute cholecystitis, but there is no definite answer to this argument. Therefore, we studied our 84 acute cholecystitis cases with clinical signs and diagnostic images in order to establish the criteria for surgical selection. This study was to find out for which patients conservative treatment is not adequate. Ultrasonographic (US) study was done to examine (1) US findings during hospitalization (2) US findings of early surgical cases (3) US findings of cases on standby surgery. Early surgery was indicated for 23 patients (27%). Sixty-one patients (73%) could be treated by conservative treatment in the acute stage, and 51 patients underwent elective operations and 10 were discharged without surgery. Of clinical findings, not only pain, fever and local tenderness but also defence musclulare and jaundice were seen in early surgery cases. Severe complications such as liver and/or subphrenic abscess, severe cholangitis, panperitonitits, renal disturbance, toxic dermatitis and shock were found in early surgery cases. Of US findings, not onlyt local tenderness, enlarged gallbladder, thickened gallbladder wall, sonolucent layer and debris in the gallbladder but also bile duct dilatation, liver abscess and fluid collection were seen in early surgical cases.