Biliary injuries during cholecystectomy represent serious adverse events that can have a profound impact on the patient’s quality of life and on the surgeon’s well-being and career. Sometimes, they can have an unexpectedly disastrous effect on the whole community, as demonstrated by the case of Anthony Eden, former foreign secretary and prime minister of Britain in the 1950s. Mr. Eden, later Lord Avon, had been suffering from biliary symptoms for a while when he had his cholecystectomy performed on April 12, 1953. On post-op day 1, a bile leak was evident, possibly due to a complete transection of the common bile duct. After a first reoperation to drain a bile collection, the definitive repair was performed in Boston by Dr. Cattell on June 10, 1953, with a loop hepatico-jejunostomy. Unfortunately, the bilioenteric anastomosis became gradually narrow, causing recurrent cholangitis, and Mr. Eden started a symptomatic treatment with pethidine, barbiturate, and amphetamine. These could have affected his perception of reality and his political judgement during the Suez Canal Crisis and, other than being the ultimate reason for 3,000+ war casualties, might have caused a Third World War. The historical and clinical implications of this case are thoroughly discussed.
Dig Surg

中文翻译：

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胆囊切除术中医源性胆道损伤：一个历史案例及其政治后果的批判性回顾

胆囊切除术期间的胆汁损伤是严重的不良事件，会对患者的生活质量以及外科医生的幸福感和职业产生深远的影响。有时，它们会对整个社区产生意想不到的灾难性影响，正如 1950 年代英国前外交大臣兼首相安东尼·伊登 (Anthony Eden) 的案例所证明的那样。1953 年 4 月 12 日，Eden 先生，即后来的 Avon 勋爵，在接受胆囊切除术时一直患有胆道症状。在术后第 1 天，胆汁泄漏很明显，这可能是由于胆囊的完全横断所致。胆总管。在第一次再次手术引流胆汁后，Cattell 博士于 1953 年 6 月 10 日在波士顿进行了最终修复，采用环肝空肠造口术。很遗憾，胆肠吻合口逐渐变窄，导致胆管炎反复发作，Eden先生开始给予哌替啶、巴比妥、苯丙胺对症治疗。这些可能影响了他在苏伊士运河危机期间对现实的看法和他的政治判断，除了成为 3,000 多人战争伤亡的最终原因之外，还可能引发了第三次世界大战。彻底讨论了该病例的历史和临床意义。
挖掘手术