经皮经肝胆囊穿刺引流联合二期小切口胆囊切除在高龄高危急性梗阻性胆囊炎中的应用  

Percutaneous transhepatic cholecystostomy followed by mini-laparotomy cholecystectomy for acute obstructive cholecystitis in the high-risk elderly

作　　者：侯克柱[1] 龚华[1] 朱松[1] 刘伟[1] 胡伟杲[1] 

机构地区：[1]上海市杨浦区市东医院普外科,200438

出　　处：《中华肝胆外科杂志》2012年第6期424-426,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨B超引导下经皮经肝胆囊穿刺引流（PTGD）联合二期小切口胆囊切除（MC）术治疗高龄、高危急性梗阻性胆囊炎患者的效果。方法回顾性分析2008年1月-2010年12月期间接受PTGD＋MC治疗的120例高龄高危急性梗阻性胆囊炎患者的临床资料。结果120例均穿刺置管成功。置管引流后2～3h腹痛均减轻，体温24～48h降至正常，平均置管时间10d。97例于1周后行MC，23例于2周后行MC。胆囊床出血1例，胆漏0例，全组无一例因急性梗阻性胆囊炎及相关的治疗而发生严重并发症或死亡。结论PTGD联合二期MC治疗高龄、高危急性梗阻性胆囊炎，充分发挥微创技术创伤小、出血少、准确安全的优势，是一项安全、简便、有效的方法。Objective To study the use of ultrasound-guided percutaneous transhepatic chole- cystostomy （PTGD） followed by selective minilaparotomy cholecystectomy （MC） for acute obstructive cholecystitis in the high-risk elderly. Method A retrospective study was conducted on 120 patients who received ultrasound-guided PTGD followed by selective MC from January 2008 to December 2010. Results PTGD＋MC were performed successfully on 120 patients with acute severe obstructive chole- cystitis. In all the patients, the abdominal pain was relieved within 2--3 h of operation, and the tem- perature decreased to normal from 24- 48 h after operation. The average time of drainage was 10 days. In 97 patients MC was performed 1 week after PTGD, and in 23 patients 2 weeks after PTGD. Bleeding from gallbladder bed occurred in 1 patient. No patient suffered from bile leak. There was no major complication or death after PTGD＋MC. Conclusion PTGD followed by selective MC is a simple, efficacious and minimally invasive treatment for high-risk elderly patients with acute obstruc- tive cholecystitis.

关 键 词：胆囊炎 高龄 微创手术 

分 类 号：R657.4[医药卫生—外科学]