Cholelithiasis and fitness for work at sea.

P Głombiowski, B Jaremin, W Bartelik, M Starnawska, E Kotulak
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Abstract

The aim of the present study was to investigate the occurrence of cholelithiasis in the occupationally active population of seamen and deep-sea fishermen aged 20-60, to assess the impact of environmental and dietary factors upon its course and to evaluate the fitness for work at sea of persons with biliary stones. The study group comprised 36 seamen and fishermen who received surgical treatment because of symptoms and complications of cholelithiasis, and 1000 seamen and fishermen periodically examined among whom 34 cases of asymptomatic cholelithiasis were diagnosed. The diagnosis was based on the anamnesis, physical examination and usg examination of the gallbladder and biliary ducts, in selected cases supplemented by other examinations. It was demonstrated that the factors which are concomitant and stimulate the development of biliary stones in seamen and fishermen were obesity and alcoholism. No role of hyperlipidemia and the type of diet in the formation of biliary stones was confirmed. In the group of 36 patients, the indications for the surgical treatment were complications of choletithiasis, i.e. biliary duct stones, mechanical jaundice, acute hydrops or empyema of the gallbladder. They resulted in temporary unfitness for work at sea. Asymptomatic cholelithiasis in seamen and fishermen does not result in unfitness for work at sea and is not an indication for surgical treatment.

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胆石症和适合海上工作。
本研究的目的是调查20至60岁从事职业活动的海员和深海渔民中胆石症的发生情况,评估环境和饮食因素对其病程的影响,并评估胆结石患者是否适合在海上工作。研究对象为36名因胆石症症状和并发症接受手术治疗的海员和渔民,定期检查1000名海员和渔民,其中34例被诊断为无症状胆石症。诊断依据回顾性检查、体格检查和胆囊胆管使用检查,在选定病例的基础上辅以其他检查。结果表明,肥胖和酗酒是海员和渔民胆结石发生的共同因素。没有证实高脂血症和饮食类型在胆结石形成中的作用。本组36例患者,手术治疗指征为胆道结石、机械性黄疸、急性胆囊积液或脓肿等胆石症并发症。结果暂时不适合在海上工作。海员和渔民的无症状胆石症不会导致不适合在海上工作,也不是手术治疗的指征。
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