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M94A0189.TXT
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1994-10-08
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Document 0189
DOCN M94A0189
TI Cholecystectomy for cholecystitis in patients with acquired immune
deficiency syndrome.
DT 9412
AU Wind P; Chevallier JM; Jones D; Frileux P; Cugnenc PH; General and
Digestive Surgical Service, Hopital Laennec, Paris,; France.
SO Am J Surg. 1994 Sep;168(3):244-6. Unique Identifier : AIDSLINE
MED/94361228
AB Acalculous cholecystitis, a recognized manifestation of acquired immune
deficiency syndrome (AIDS), causes abdominal pain which can be relieved
by cholecystectomy. The indications for cholecystectomy have remained
undefined, however, because the cholecystitis is usually accompanied by
generalized cholangitis and it is difficult to distinguish the relative
clinical importance of the two problems. Since 1985, we have performed
cholecystectomy on 8 patients with AIDS who had clinical manifestations
of acute cholecystitis associated with a thickening of the gallbladder
wall by 5 mm to 12 mm. Two of the 8 had gallstones and 4 had associated
cholangitis. All had been treated with antibiotics for 20 to 180 days
before surgery, but physical deterioration had progressed in every case.
At the moment of surgical intervention, 4 patients had multiple organ
failure. One patient died 3 days postoperatively, but the rest recovered
rapidly with resolution of the abdominal pain and sepsis. Two patients
died 20 days after surgery due to complications of AIDS. The remaining 5
died due to AIDS at 6, 9, 10, 12, and 14 months after surgery. Two of
this group developed progressive cholangitis with raised serum alkaline
phosphatase. Our experience indicates that cholecystectomy should be
considered for the treatment of severe and persistent symptoms of
hepatobiliary manifestations of AIDS notwithstanding the presence of
cholangitis.
DE Adult AIDS-Related Opportunistic Infections/*SURGERY
Cholangitis/COMPLICATIONS *Cholecystectomy
Cholecystitis/COMPLICATIONS/*SURGERY Female Human Male Middle Age
Treatment Outcome JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).