B超定位胆囊穿刺造瘘术治疗高龄急性胆囊炎78例报告

Ultrasound-guided percutaneous cholecystostomy for elderly patients with acute cholecystitis:a report of 78 cases

目的：探讨B超定位胆囊穿刺造瘘术对高龄急性胆囊炎患者的疗效。方法：分析2003—08～2006—08我科以B超定位胆囊穿刺造瘘术治疗的78例高龄（≥70岁）急性胆囊炎患者的临床资料，78例入院前合并各种疾病者72例（92．3％）。结果：78例全部成功施行穿刺造瘘（100％），无出血、胆瘘等并发症发生，74例治愈出院（94．9％），4例（5．1％）死亡，出院51例（65．4％）3个月后行腹腔镜胆囊切除，术后患者恢复好。结论：B超定位胆囊穿刺造瘘可迅速缓解高龄患者急性胆囊炎引起的危急症状，避免急诊开腹手术带来的风险，具有微创、方便、安全等优势，可明显降低死亡率，值得推广。

Objective：To investigate the therapeutic efficacy of percutaneous cholecystostomy under ultrasonic guidance for elderly patients with acute cholecystitis. Methods： The clinical data of 78 elderly patients （age≥ 70 ） with acute cholecystitis receiving percutaneous cholecystostomy from Aug 2003 to Aug 2006 were analyzed retrospectively. Among them, 72 patients were complicated with various chronic diseases. Results： Ultrasound , guided percutaneous cholecystostomy was performed successfully in all patients, and no complication was found. Seventy -four patients were cured and 4 patients died. Fifty -one patients received laparoscopic cholecystectomy after 3 months of discharge. Conclusion：Ultrasound -guided percutaneous cholecystostomy can promptly reheve severe symptoms for elderly patients with acute cholecystitis and avoid the risks of emergency operation, which has the advantages of less injury, simple manipulation, safety and lower mortality.