急性重症胆囊炎的介入治疗

目的评价利用经皮胆囊造口术治疗急性重症胆囊炎的临床疗效。方法97例急性重症胆囊炎患者接受超声及DSA结合导引下的经皮胆囊造口术,并于术中置管引流。结果所有97例患者均一次置管成功,无任何并发症。93例(96%)患者临床体征如右上腹疼痛、发热在72h内缓解;同时,血常规中的WBC及中性粒细胞均于72h内降至正常范围。4例患者由于肝总管内结石合并胆管炎临床症状缓解不明显而于第2天行经皮肝穿胆管引流术,术后临床症状于72h内亦缓解。结论经皮经肝胆囊穿刺置管引流术是治疗急性重症胆囊炎安全有效的方法。

Percutaneous cholecystostomy for the treatment of acute severe cholecystitis

Objective To evaluate the clinical efficacy and outcomes of percutaneous cholecystostomy for acute severe cholecystitis. Mehtods 97 critically ill patients with acute cholecystitis underwent emergency percutaneous cholecystostomy under guidance of US and DSA. Results All patients underwent percutaneous cholecystostomy with technical success without major periprocedural complications. 93(96%) patients responded well clinically showing disappearance of right upper abdomen pain and fevers within 72hr. 4 patients complicated with common bile duct stones were underwent PTCD one day after the procedure because of no response clinically. After PTCD, all 4 patients attained clinical symptom relief within 72hr. Conclusions Percutaneous cholecystostomy is a safe and effective treatment adaptable for critically ill patients with acute cholecystitis.