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目的：总结B超引导下经皮经肝胆囊穿刺引流(PTGD)对高龄高危急性胆囊炎病人的治疗经验。方法：回顾性分析1990年1月至2001年12月期间接受PTGD治疗的113例高龄高危急性胆囊炎病人的临床资料。结果：113例均穿刺置管成功。12例因引流管脱落或堵塞而再次行PTGD。110例(97．3％)获得有效的胆囊引流。108例(95．6％)治愈。91例于急性胆囊炎治愈后2周至3个月行择期胆囊切除术。3例行胆囊的“化学性切除”。1例发生胆囊出血。2例出现胆汁腹腔漏。全组无一例因急性胆囊炎及相关的治疗而死亡。3例行胆囊化学性切除者随访分别迭1．5、2及3年，病人无症状出现。并且B超证实胆囊腔完全闭锁。结论：PTGD是治疗高龄高危急性胆囊炎病人的一项安全、简便、有效的方法。

Percutaneous transhepatic gallbladder drainage for acute cholecystitis in the elderly and high-risk patients

Objective To summarize the experience drawn from treatment of elderly and high-risk patients with acute cholecystitis by ultrasound-guided percutaneous transhepatic gallbladder drainage(PTGD).Methods The clinical data of 113 patients who underwent PTGD between January 1990 and December 2001 were analyzed retrospectively. Results PTGD was successfully performed in all patients. This procedure was repeated in 12 cases because of downfall or block of drainage catheter. Gallbladder drainage was effective in 110 patients(97 3%), 108 patients(95 6%) were cured. Selective cholecystcetomy was performed in 91 cases from 2 weeks to 3 months after PTGD. Three patients underwent chemical resection . Gallbladder hemorrhage occurred in 1 case, and bile leak occurred in 2 patients. No patient died of acute cholecystitis. Those patients who underwent chemical resection remained well during 1 5, 2 and 3 years' follow-up respectively.Conclusion PTGD is a safe, simple and effective procedure for treatment of elderly and high-risk patients with acute cholecystitis.