急性无结石性坏疽性胆囊炎临床诊治分析

DIAGNOSIS AND TREATMENT OF ACUTE ACALCULOUS GANGRENOUS CHOLECYSTITIS IN 43 CASES

目的探讨急性无结石性坏疽性胆囊炎的诊断及外科治疗方法。方法对2000～2006年收治的26例急性无结石性坏疽性胆囊炎的临床资料进行回顾性分析。结果本组26例病人中,23例行胆囊切除术,其中3例行胆囊切除加胆总管探查、T型管引流术;3例行胆囊大部分切除术。术后1例死亡,死因为中毒性休克,多器官功能衰竭。结论B超和白细胞检查结合临床症状及体征是诊断本病的主要方法。早期诊断、完善的术前准备,早期积极的手术治疗可提高本病的治愈率。

Objective To investigate the diagnosis and treatment of acute aealculous gangrenous cholecystitis （AAGC）. Methods The clinical data of 26 patients with AAGC treated in our hospital from 2000 to 2006 were retrospectively analyzed. Results All patients with AAGC were surgically treated when the final diagnosis was confirmed. Of the 26 patients , 23 underwent cholecystectomy, 3 partial cholecystectomy and 3 cholecystectomy, exploration of common bile duct and T-tube drainage. One patient died after operation for the cause of toxic shock and multiple organ failure. Conclusions B-mode uhrasonography, laboratory examination, symptoms and clinical signs are the main methods for diagnosis of AAGC. Early diagnosis, careful preoperative preparation and surgical therapy are important to raise curative rate of the disease.