经皮经肝胆囊穿刺引流术在急性重症胆囊炎的应用

Percutaneous transhepatic gallbladder drainage for the treatment of severe acute cholecystitis

目的:评价经皮经肝胆囊穿刺引流术(percutaneous transhepatic gallbladder drainage,PTGBD)治疗重症急性胆囊炎的价值。方法:89例符合条件的急性重症胆囊炎患者均行PTGBD,对置管中、置管后出现的并发症进行回顾性分析。结果:89例均完成PTGBD,2例出现导管推送困难;3例胆道出血;3例导管脱出;5例导管堵塞;1例随访中出现急性胰腺炎,所有患者均于PTGBD术后1个月后行腹腔镜下胆囊切除术(laparoscopic cholecystectomy LC),无需中转开腹,无胆管损伤及严重并发症的出现。结论:PTGBD可作为急性重症胆囊炎的一种早期、安全、有效的治疗方法。

Objective： To evaluate results of the protocol using percutaneous transhepatic gallbladder drainage （PTGBD） in the treatment of severe acute cholecystitis. Methods： Eighty-nine patients consistent with the conditional severe acute cholecystitis underwent the PTGBD. A retrospective investigation for complication of the operation was carried out. Re- sults： All patients accomplished the operation. Two patients appeared incorrect catheter positioning, two patients hemobi- lia, there patients catheter dislodgment, five patients catheter obstruct, and one patient appeared acute pancreatitis. All patients were completed successfully by LC after one month without converting into open surgery, and no bile duet injuries or other severe complication occurred. Conclusion： PTGBD for the treatment of severe acute choleeystitis is an initial, safe, effective therapeutic way.