老年结石性急性胆囊炎经皮肝胆囊穿刺引流联合腹腔镜胆囊切除术与单纯行腹腔镜胆囊切除术的比较分析  

The Comparative Analysis of Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy and Direct Laparoscopic Cholecystectomy for Treatment of old Patients with Acute Calculous Cholecystitis

作　　者：许帅[1] 李为民[2] 刘浩润[2] 郑方[2] 戴新[2] 赵洪强[2] 

机构地区：[1]中国人民解放军总医院解放军医学院,北京100853 [2]中国人民解放军三〇九医院肝胆外科,北京100091

出　　处：《临床消化病杂志》2013年第6期321-323,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的探讨对老年结石性急性胆囊炎患者应用B超引导下经皮肝胆囊穿刺引流术(percutaneous transhepatic gallbladder drainage,PTGD)联合腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的临床意义。方法回顾分析2004年1月到2011年12月我科室收治的130例老年结石性急性胆囊炎患者资料,其中行PTGD后联合LC的70例,单纯行LC的老年结石性急性胆囊炎患者60例,对两组进行对比分析。结果在B超引导下PTGD联合LC组中,无并发症发生病例,中转开腹1例,腹腔引流10例,平均LC手术时间46min,术后平均住院时间7.7d;在单纯LC组中,并发症发生1例,中转开腹3例,腹腔引流36例,平均LC手术时间91min,术后平均住院时间13.6d。两组比较,在中转开腹率、腹腔引流率、LC手术时间、腹腔镜胆囊切除术后住院时间,差异均有统计学意义(P<0.05),LC术后并发症率差异无统计学意义(P>0.05)。结论 PTGD联合LC治疗老年胆囊结石伴急性胆囊炎较LC更具优势。Abstract： Objective To evaluate the clinical value of the treatment in old patients with acute calculous cholecystitis by percutaneous transhepatic gallbladder drainage （PTGD）combined with laparoscopic cholecystectomy （LC） . Methods The clinical data of 130 old patients with acute cholecystitis hospitalized in our center from January 2004 to December 2011 were retrospectively analyzed. Seventy of them received PTGD combined with LC, and 60 of them received direct LC. The clinical data of two groups were analyzed and compared. Results The clinical data of the group which received PTGD combined with LC showed lower in conversion to laparotomy rate, peritoneal drainage rate , and shorter in operative time , hospital stay. Com- paring to those in directly LC group, the data showed statistical significance （ P 〈 0.05 ） However, there was no statistical signifi- cance in complication rate between the two groups. Conclusion The combination of PTGD with LC shows much more advan- tage than direct LC method for old patients with acute calculus choleeystitis.

关 键 词：老年人 急性结石性胆囊炎 经皮肝胆囊穿刺引流术 腹腔镜胆囊切除术 

分 类 号：R657.4[医药卫生—外科学]