Elective cholecystectomy in children with sickle hemoglobinopathies. Successful outcome using a preoperative transfusion regimen.
Elective cholecystectomy in children with sickle hemoglobinopathies. Successful outcome using a preoperative transfusion regimen.
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镰状血红蛋白病儿童的选择性胆囊切除术。
DOI：
10.1097/00000658-198807000-00003
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发表时间：
1988
影响因子：
9
通讯作者：
Kinney,TR
中科院分区：
文献类型：
--
作者：
Ware,R;Filston,HC;Schultz,WH;Kinney,TR
摘要27位患有镰状血红蛋白病的儿童因胆石症而接受选择性胆囊切除术。所有患者均采用术前输血方案进行管理，以使血红蛋白浓度达到11-14 g/dl，血红蛋白A大于65%。术中胆道造影发现胆总管结石的五名患者，虽然只有一个案例是由术前超声检查诊断。24名儿童接受意外阑尾切除术的全肠套叠。无血管闭塞事件或任何其他围手术期发病率或死亡率。胆囊切除术后四个月，一名男孩出现小肠梗阻，需要手术重新探查。没有患者发生输血获得性感染，尽管有一名男孩对刘易斯A抗原有红细胞同种过敏。这种术前输血方案和仔细的围手术期管理允许镰状细胞病儿童安全选择性胆囊切除术。
Twenty-seven children with major sickle hemoglobinopathies underwent elective cholecystectomy for cholelithiasis. All were managed with a preoperative transfusion regimen to achieve a hemoglobin concentration of 11-14 g/dl with greater than 65% hemoglobin A. Intraoperative cholangiography revealed common bile duct stones in five patients, although only one case was diagnosed by preoperative ultrasonographic examination. Twenty-four children underwent incidental appendectomy by total intussusception. There were no vaso-occlusive events nor any other perioperative morbidity or mortality. Four months after cholecystectomy, one boy had a small bowel obstruction requiring surgical re-exploration. No patients had transfusion-acquired infection, although one boy had erythrocyte allosensitization to Lewis A antigen. This preoperative transfusion regimen and careful perioperative management permits safe elective cholecystectomy in children with sickle cell disease.