经皮胆囊穿刺造瘘处理高危急性胆囊炎53例分析

目的 评价B超引导下经皮胆囊穿刺造瘘(percutaneous cholecystostomy,PC)处理高危急性胆囊炎患者的有效性和治疗经验.方法 回顾性分析1999年1月至2005年8月接受PC治疗的53例高危急性胆囊炎患者的临床资料.结果 53例均穿刺置管成功,4例因引流管脱落或堵塞而再次行PC.52例(98.1%)获得有效的胆囊引流,1例患者(1.9%)术后病情转坏,术后1 d行了紧急胆囊切除术. 41例于急性胆囊炎治愈后2周至3个月行择期胆囊切除术,全组无1例因经皮胆囊穿刺引流术引起的并发症死亡.随访分别达6个月至3年.结论 经皮胆囊穿刺造瘘术是治疗高危急性胆囊炎患者的一项安全、简便、有效的方法.它有较高的成功率和较低的并发症.

Percutaneous cholecystostomy for acute cholecystitis in 53 high-risk patients

Objective To evaluate the clinical efficacy and outcomes of percutaneous cholecystostomy(PC) under type-B ultrasonic guide as an alternative treatment option for critically ill patients of acute cholecystitis.Methods The clinical data of 53 high-risk patients of acute cholecystitis were retrospectively analyzed,who received PC from January 1999 to August 2005.Results All cases were successfully punctured and intubated,and 4 received reoperation because of blocked tube or fall-off.Fifty-two(97.3%) gained bile drainage effectively.No complications occurred due to the procedures in the cholecystostomy and intubation.One patient required emergency cholecystectomy on day 1 after the procedures because of deteriorating conditions.Forty-one accepted selective cholecystectomy in 2 weeks to 3 months after cholecystostomy.The follow-up period was 6 months to 3 years.Conclusion PC is an effective,convenient and safe method in managing acute cholecystitis in high-risk patients,with high achievement ratio and less complications.