{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T23:14:23Z","timestamp":1648854863226},"reference-count":27,"publisher":"Akademiai Kiado Zrt.","issue":"45","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,11,1]]},"abstract":"<jats:p>Napjainkban az epeh\u00f3lyag-k\u00f6vess\u00e9g eset\u00e9ben a laparoszk\u00f3pos cholecystectomia a standard m\u0171t\u00e9ti megold\u00e1s. Az ellenjavallatok k\u00f6re cs\u00f6kkent, ma m\u00e1r nem sz\u00e1m\u00edt egy\u00e9rtelm\u0171 kontraindik\u00e1ci\u00f3nak p\u00e9ld\u00e1ul a kor\u00e1bbi hasi m\u0171t\u00e9t, a s\u00falyos epeh\u00f3lyag-gyullad\u00e1s, illetve a\u00a0gravidit\u00e1s sem. A laparoszk\u00f3pos technika el\u0151nye \u00e9s haszna m\u00e1jcirrhoticus betegek eset\u00e9ben m\u00e9g bizonytalan. \n <jats:italic>M\u00f3dszer \u00e9s betegek:<\/jats:italic>\n A\u00a0Semmelweis Egyetem I. Seb\u00e9szeti Klinik\u00e1j\u00e1n 1996 \u00e9s 2006 k\u00f6z\u00f6tt 52, m\u00e1jcirrhosisban szenved\u0151 \u00e9s epeh\u00f3lyag-k\u00f6vess\u00e9g miatt m\u0171t\u00e9tre ker\u00fclt beteg adatait dolgozt\u00e1k fel retrospekt\u00edv tanulm\u00e1ny form\u00e1j\u00e1ban. A n\u0151-f\u00e9rfi ar\u00e1ny 2,7:1, az \u00e1tlag\u00e9letkor 58,5 \u00e9v (31\u201387) volt. A betegek Child szerinti megoszl\u00e1sa: A = 36, B = 14 \u00e9s C = 2. Huszonh\u00e1rom hagyom\u00e1nyos (open cholecystectomia \u2013 OC) \u00e9s 29 laparoszk\u00f3pos (LC) cholecystectomi\u00e1t v\u00e9geztek, az ut\u00f3bbiak k\u00f6z\u00fcl 4 esetben konverzi\u00f3ra k\u00e9nyszer\u00fcltek. \n <jats:italic>Eredm\u00e9nyek:<\/jats:italic>\n Az \u00e1tlagos m\u0171t\u00e9ti id\u0151 Child A, B cirrhoticus betegekn\u00e9l LC eset\u00e9ben 86,5 perc, hagyom\u00e1nyos m\u0171t\u00e9tn\u00e9l 86,21 perc volt. Child C cirrhoticus betegekn\u00e9l mindk\u00e9t esetben ny\u00edlt cholecystectomia t\u00f6rt\u00e9nt, az \u00e1tlagos m\u0171t\u00e9ti id\u0151 81,5 perc volt. Posztoperat\u00edv sz\u00f6v\u0151dm\u00e9ny (Child A, B) 8 esetben fordult el\u0151 (LC\/1, OC\/7), m\u00edg a Child C p\u00e1ciensekn\u00e9l mindk\u00e9t esetben. Az \u00e1tlagos k\u00f3rh\u00e1zi tart\u00f3zkod\u00e1s 7,6 (LC), illetve 12,45 (OC) nap volt. Ugyanez a Child C betegekn\u00e9l 28 napra emelkedett. A posztoperat\u00edv szakban 4 beteget vesztettek el, mindegyik\u00fck ny\u00edlt cholecystectomi\u00e1n esett \u00e1t, Child B (3 beteg), illetve Child C (1 beteg) st\u00e1dium\u00fa m\u00e1jcirrhosisban szenvedett, \u00e9s befoly\u00e1solhatatlan hepatorenalis szindr\u00f3ma alakult ki. \n <jats:italic>K\u00f6vetkeztet\u00e9s:<\/jats:italic>\n Eredm\u00e9ny\u00fck alapj\u00e1n kompenz\u00e1lt, Child A \u00e9s B st\u00e1dium\u00fa cirrhoticus betegekn\u00e9l az LC biztons\u00e1gos elj\u00e1r\u00e1s. B\u00e1r a m\u00e1jcirrhosis a m\u0171t\u00e9ti kock\u00e1zatot extr\u00e9m m\u00e9rt\u00e9kben megn\u00f6veli, valamint a sz\u00f6v\u0151dm\u00e9nyek lehet\u0151s\u00e9g\u00e9t, a hospitaliz\u00e1ci\u00f3t \u00e9s a m\u0171t\u00e9t idej\u00e9t is emeli, a cirrhoticus betegek szimpt\u00f3m\u00e1s cholelithiasisa egy\u00e9rtelm\u0171 m\u0171t\u00e9ti javallatot k\u00e9pez.<\/jats:p>","DOI":"10.1556\/oh.2008.28450","type":"journal-article","created":{"date-parts":[[2008,11,6]],"date-time":"2008-11-06T03:19:35Z","timestamp":1225941575000},"page":"2129-2134","source":"Crossref","is-referenced-by-count":2,"title":["Cirrhosis and cholelithiasis. Laparoscopic or open cholecystectomy?"],"prefix":"10.1556","volume":"149","author":[{"given":"Levente","family":"D\u00e9ry","sequence":"first","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar I. Seb\u00e9szeti Klinika Budapest \u00dcll\u0151i \u00fat 78. 1082"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"Galambos","sequence":"additional","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar I. Seb\u00e9szeti Klinika Budapest \u00dcll\u0151i \u00fat 78. 1082"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e9ter","family":"Kupcsulik","sequence":"additional","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar I. Seb\u00e9szeti Klinika Budapest \u00dcll\u0151i \u00fat 78. 1082"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e9ter","family":"Lukovich","sequence":"additional","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar I. 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