经皮肝胆囊穿刺引流联合腹腔镜胆囊切除术治疗高龄高危急性梗阻化脓性胆囊炎56例  

Combination of Percutaneous Transhepatic Gallbladder Drainage with Laparoscopic Cholecystectomy in the Treatment of Acute Obstruction Suppurative Cholecystitis in High-risk and Elderly Patients

作　　者：陆启瑜[1] 周阳[1] 宛宝生[1] 

机构地区：[1]昆明医科大学第二附属医院胃肠外科,云南昆明650101

出　　处：《昆明医科大学学报》2016年第3期71-73,共3页Journal of Kunming Medical University

基　　金：卫生部医药卫生科技发展基金资助项目(W2011JZC29)

摘　　要：目的探讨经皮肝胆囊穿刺引流(PTGD)联合腹腔镜胆囊切除治疗高龄高危急性梗阻化脓性胆囊炎的疗效.方法回顾性分析2013年12月至2014年12月56例高龄高危急性梗阻化脓性胆囊炎患者,先行PTGD,1个月后再行腹腔镜胆囊切除术的临床资料.结果 56例患者均成功接受PTGD,穿刺后均无胆汁瘘、出血等明显并发症,穿刺后24 h相关症状明显缓解.全部患者于术后1个月行二期腹腔镜胆囊切除术,其中3例中转开腹(5.3%),术后无胆汁漏及胆管损伤等严重并发症发生.结论高危高龄急性梗阻化脓性胆囊炎经PTGD治疗后,可迅速缓解症状,避免急诊手术及麻醉风险,术后1个月再实施腹腔镜胆囊切除术时中转开腹率低,手术并发症少.Objective To investigate the clinical efficacy of percutaneous transhepatic gallbladder drainage（PTGD） combined with laparoscopic cholecystectomy（LC） in the treatment of acute obstruction suppurative cholecystitis in high-risk and elderly patients. Methods Retrospective analysis was made on the clinical data of 56 patients with acute severe cholecystitis who underwent PTGD and two-stage LC from Sep 2013 to Sep 2014. Results PTGD was performed successfully for all patients. There were no biliary fistula,bleeding and other complications after PTGD. The symptoms of abdominal pain were relieved at 24 h after operation. And all cases were performed LC after 30 days of PTGD, in which 3 patients were transferred to open cholecystectomy（5.3%）. No patient had severe complication or died after LC. Conclusion With the low conversion to open surgery and less complications,PTGD combined two-stage LC is simple, effective and safe for the treatment of acute obstruction suppurative cholecystitis in high-risk and elderly patients.

关 键 词：急性胆囊炎 经皮肝胆囊穿刺引流 高龄 

分 类 号：R657.41[医药卫生—外科学]