PTGD联合LC治疗高龄高危急性结石性胆囊炎32例  

Percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy for treatment of 32 elderly critical patients with acute calculous cholecystitis

作　　者：江宗兴[1] 汪涛[1] 杨锁军[1] 刘彦莉[1] 林宁[1] 

机构地区：[1]成都军区总医院全军普外中心,成都610083

出　　处：《西南国防医药》2011年第8期842-844,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的总结经皮肝胆囊穿刺引流(PTGD)联合腹腔镜胆囊切除术(LC)对高龄高危急性结石性胆囊炎患者的治疗经验。方法回顾分析我中心2008年5月～2010年5月采用PTGD联合LC序贯治疗32例高龄高危结石性胆囊炎患者的临床资料。结果 32例均穿刺置管,全部获得有效引流,1 w～3个月后行LC,中转开腹4例;无出血及漏胆等并发症,无死亡病例;LC术后5～6 d治愈出院,中转开腹病例8～10 d拆线后出院。结论 PTGD联合LC治疗高龄高危急性结石性胆囊炎是一种安全、微创、有效的方法,避免因急诊手术引起的并发症,提高了生活质量,体现了以人为本的治疗理念。Objective To summarize the experiences of treatment of elderly critical patients with acute calculous cholecystitis by percutaneous transhepatic gallbladder drainage（PTGD） combined with laparoscopic cholecystectomy（LC）.Methods The clinical data of 32 elderly critical patients with acute cholecystitis hospitalized in our center from May 2008 to May 2010 were retrospectively analyzed.They all received PTGD initially,and then routine measures were taken to control the complications such as hypertension,diabetes,pulmonary infection for 1 w-3 months.After that,LC was performed;oxygen inhalation,electrocardiographic monitoring and anti-infection were conducted postoperatively.Results PTGD was successful and effective drainage was obtained in 32 cases.4 cases underwent laparotomy due to the failure of LC.Neither bleeding nor bile leakage was found.Patients receiving LC were discharged in 5-6 d postoperatively,while those undergoing laparotomy did in 8-10 d.Conclusion The combination of PTGD with LC is a safe,minimally invasive and effective method for elderly critical patients with acute calculous cholecystitis.It can reduce the complications caused by emergent surgery,and therefore improve patients＇ quality of life.

关 键 词：经皮胆囊穿刺引流 腹腔镜胆囊切除术 老年 急性结石性胆囊炎 

分 类 号：R657.41[医药卫生—外科学]