宫腔镜下电凝胆囊粘膜消除术治疗高危胆囊炎的初步报告

PRELIMINARY REPORT OF THE GALLBLADDER MUCOSA OBLITERATION WITHHYSTEROSCOPIC ELECTROCOAGULATION FOR HIGH-RISK CHOLECYSTITIS

目的 对宫腔镜下高频电凝消除胆囊管及胆囊粘膜的效果进行评估。方法 12例高危胆囊炎病人先在局麻下行胆囊造瘘术。术后 4周病情稳定后在硬膜外麻醉下行宫腔镜检查和治疗。分别用滚球和滚棒电极电凝消除胆囊管及胆囊粘膜 ,电凝功率为 6 0～ 70W ,滚棒移动速度为 10～ 15mm/sec。结果 内镜下操作时间为 2 5～ 5 5min (平均 35min) ,术后 6个月内胆囊腔完全闭合者 6例 ,其余未闭合者胆囊已萎缩 ,且仍在术后 6月之内。结论 内镜下电凝消除胆囊管及胆囊粘膜是胆囊造瘘后一期胆囊硬化闭塞的可行方法。

Objective To evaluate a method of gallbladder mucosa obliteration by hysteroscopic electrocoagulation.Methods Twelve patients with high-risk cholecystitis had been performed mini-cholecystostomy under local anesthesia. After 4 weeks when the they were stable , the patients were treated with histeroscopy under epidural anesthesia. The mucosae of the cystic duct and gallbladder were ablated with the roller-ball and the roller-bar electrodes respectively. The electrocoagulation power was 60～70W with the roller-bar moving speed of 10-15mm/s. Results The manipulation under the endoscope took 25～55 minutes (average 35min). Six patients had their gallbladders completely sclerosed in six months of the manipulation. The others who were still in 6-month's follows-up had all the gallbladders shrunken.Conclusion Endoscopic electrocoagulation is a practical single-phase method for ablation of the gallbladder.