超声引导经皮经肝胆囊穿刺置管引流治疗老年急性非结石性胆囊炎的可行性及疗效

Experience of ultrasound--guided percutaneous transpepatic gallbladder drainage on treatment of elderly with acute acalculous cholecystitis

[目的]探讨超声引导经皮经肝胆囊穿刺置管引流治疗老年急性非结石性胆囊炎的可行性及疗效。[方法]对21例急性非结石性胆囊炎的老年患者，入院后急诊行超声引导经皮经肝胆囊穿刺置管引流术，术后常规禁食水、补液、对症支持治疗，术后3～4周择期拔管。[结果]21例均在超声引导下顺利完成穿刺置管引流术，无胆瘘、出血、胃肠道损伤、血气胸等严重并发症发生，术后1例引流管自行脱出、1例出现胆囊区局限性积液、1例出现引流管阻塞；术后患者症状消失、复查超声胆囊均基本恢复正常。[结论]老年急性非结石性胆囊炎患者经超声引导经皮经肝胆囊穿刺置管引流安全可行、效果良好。

[Objective]To evaluate the feasibility and efficacy of ultrasound-guided percutaneous transpepatic gallbladder drainage in the treatment of elderly patients with acute acalculous cholecystitis. [Methods] A retrospective analysis was performed based on the clinical data of 21 elderly patients from our department from Jan 2008 to Jun 2013. All patients received emergency ultrasound--guided percutaneous transpepatic gallbladder drainage after admission to our department with routine postoperative fasting,rehydration and symptomatic support treatment. Elective extubation was performed 3-4 weeks after operation. [Results] All 21 cases were performed ultrasound--guided percutaneous transpepatic ballbladder drainage successfully. Among 21 patients,one case had the drainage tube dropped by itself,one had the gallbladder area localized hydrops and one had tube obstruction. There were no serious complications such as biliary fistula, bleeding,gastrointestinal injury, hemopneumothorax. After operation, the patient＇s symptoms disappeared and gallbladder was returned to normal showed by ultrasound. [Conclusion]The treatment of ultrasound- guided percutaneous transpepatic gallbladder drainage on elderly patients with acute acalculous cholecystitis is feasible and effective.