臨床外科74巻2号

2019年02月発行

特集 急性胆囊炎診療をマスターしよう 総論

急性胆囊炎の発症メカニズム

著者： 横江正道¹

所属機関： ¹名古屋第二赤十字病院総合内科

ページ範囲：P.158 - P.160

【ポイント】
◆急性胆囊炎の原因の90%以上は胆囊結石に由来する．
◆急性胆囊炎の早期での胆汁培養陽性率は低く，全体でも陽性率は50〜75%である．
◆無石胆囊炎は重症患者，ICU管理，陽圧換気，高カロリー輸液，熱傷などを背景に発症することが多い．

参考文献

1）Indar AA, Beckingham IJ：Acute cholecystitis. BMJ 325：639-643, 2002

2）Halpin V：Acute cholecystitis. BMJ Clin Evid 2014：pii：0411, 2014

3）Knab LM, Boller AM, Mahvi DM：Cholecystitis. Surg Clin North Am 94：455-470, 2014

4）Gouma DJ, Obertop H：Acute calculous cholecystitis. What is new in diagnosis and therapy? HPB Surg 6：69-78, 1992

5）Mack E：Role of surgery in the management of gallstones. Semin Liver Dis 10：222-231, 1990

6）Hermann RE：Surgery for acute and chronic cholecystitis. Surg Clin North Am 70：1263-1275, 1990

7）Sharp KW：Acute cholecystitis. Surg Clin North Am 68：269-279, 1988

8）Fukunaga FH：Gallbladder bacteriology, histology and gallstones：study of unselected cholecystectomy specimens in Honolulu. Arch Surg 106：169-171, 1973

9）Lou MA, Mandal AK, Alexander JL, et al：Bacteriology of the human biliary tract and the duodenum. Arch Surg 112：965-967, 1977

10）Kaminski DL：Arachidonic acid metabolites in hepatobiliary physiology and disease. Gastroenterology 97：781-792, 1989

11）Roslyn JJ, DenBesten L, Thompson JE Jr, et al：Roles of lithogenic bile and cystic duct occlusion in the pathogenesis of acute cholecystitis. Am J Surg 140：126-130, 1980

12）Jivegård L, Thornell E, Svanvik J：Pathophysiology of acute obstructive cholecystitis：implications for non-operative management. Br J Surg 74：1084-1086, 1987

13）Gu MG, Kim TN, Song J, et al：Risk factors and therapeutic outcomes of acute acalculous cholecystitis. Digestion. 90：75-80, 2014

14）Williamson RC：Acalculous disease of the gall bladder. Gut 29：860-872, 1988

15）Barie PS, Fischer E：Acute acalculous cholecystitis. J Am Coll Surg 180：232-244, 1995

16）Ryu JK, Ryu KH, Kim KH：Clinical features of acute acalculous cholecystitis. J Clin Gastroenterol 36：166-169, 2003

17）Wang AJ, Wang TE, Lin CC, et al：Clinical predictors of severe gallbladder complications in acute acalculous cholecystitis. World J Gastroenterol 9：2821-2823, 2003

18）Jönsson PE, Andersson A：Postoperative acute acalculous cholecystitis. Arch Surg 111：1097-1101, 1976

19）Laurila J, Syrjälä H, Laurila PA, et al：Acute acalculous cholecystitis in critically ill patients. Acta Anaesthesiol Scand 48：986-991, 2004

20）Theodorou P, Maurer CA, Spanholtz TA, et al：Acalculous cholecystitis in severely burned patients：incidence and predisposing factors. Burns 35：405-411, 2009

21）Walsh K, Goutos I, Dheansa B：Acute Acalculous Cholecystitis in Burns：A Review. J Burn Care Res 39：724-728, 2018

22）Parithivel VS, Gerst PH, Banerjee S, et al：Acute acalculous cholecystitis in young patients without predisposing factors. Am Surg 65：366-368, 1999

23）Petersen SR, Sheldon GF：Acute acalculous cholecystitis：a complication of hyperalimentation. Am J Surg 138：814-817, 1979

24）Flancbaum L, Majerus TC, Cox EF：Acute posttraumatic acalculous cholecystitis. Am J Surg 150：252-256, 1985

25）Sjödahl R, Tagesson C：On the development of primary acute cholecystitis. Scand J Gastroenterol 18：577-579, 1983

26）Fox MS, Wilk PJ, Weissmann HS, et al：Acute acalculous cholecystitis. Surg Gynecol Obstet 159：13-16, 1984

27）矢島幸浩：急性無石胆囊炎の発生機序に関する実験的研究-特に，虚血-再灌流障害におけるradical scavengerおよびphospholipase A2 inhibitorの効果とプロスタグランディンの関与について．胆道7：445-457，1993

28）三枝伸二，内野　靖，福元俊孝，他：急性無石胆炎—胆石症との比較．臨外58：1663-1666，2003

29）Jannuzzi C, Belghiti J, Erlinger S, et al：Cholangitis associated with cholecystitis in patients with acquired immunodeficiency syndrome. Arch Surg 125：1211-1213, 1990

30）Cello JP：AIDS-Related biliary tract disease. Gastrointest Endosc Clin N Am 8：963, 1998

31）Ono SK, Bassit L, Van Vaisberg V, et al：Acute acalculous cholecystitis during zika virus infection in an immunocompromised patient. Hepatology 67：2051-2054, 2018

32）Kottanattu L, Lava SAG, Helbling R, et al：Pancreatitis and cholecystitis in primary acute symptomatic Epstein-Barr virus infection-Systematic review of the literature. J Clin Virol 82：51-55, 2016

33）Bhatty S, Shaikh NA, Fatima M, et al：Acute acalculous cholecystitis in dengue fever. J Pak Med Assoc 59：519-521, 2009

34）Sharma N, Mahi S, Bhalla A, et al：Dengue fever related acalculous cholecystitis in a North Indian tertiary care hospital. J Gastroenterol Hepatol 21：664-667, 2006

35）Rolain JM, Lepidi H, Harlé JR, et al：Acute acalculous cholecystitis associated with Q fever：report of seven cases and review of the literature. Eur J Clin Microbiol Infect Dis 22：222-227, 2003

36）Abdur-Rahman OL, Adeniran OJ, Nasir AA：Outcome of acalculous cholecystitis from typhoid in Nigerian children. J Natl Med Assoc 101：717-719, 2009

37）Khuroo MS：Ascariasis. Gastroenterol Clin North Am 25：553-577, 1996

38）Khuroo MS, Rather AA, Khuroo NS, et al：Hepatobiliary and pancreatic ascariasis. World J Gastroenterol 22：7507-7517, 2016