超声引导下经皮经肝胆囊穿刺引流术联合择期腹腔镜胆囊切除术治疗急性重症胆囊炎的疗效观察

Percutaneous transhepatic gallbladder drainage combined with scheduled laparoscopic cholecystectomy for acute severe cholecystitis

目的观察超声引导下经皮经肝胆囊穿刺引流术(PTGD)联合择期腹腔镜胆囊切除术(LC)治疗急性重症胆囊炎的疗效。方法选取2015-04~2016-04期间该院收治的急性重症胆囊炎患者82例作为研究对象,按照手术方法的不同分为观察组(n=41)和对照组(n=41)。观察组先接受超声引导下PTGD治疗,3~4周后择期接受LC治疗,对照组接受急诊LC治疗,观察两组的治疗效果。结果观察组手术时间长于对照组,术中中转开腹率高于对照组(P<0.05),观察组并发症总发生率明显低于对照组(P<0.05)。结论对急性重症胆囊炎患者,超声引导下PTGD联合择期LC具有创伤小、并发症少等优点,安全可行,值得临床推广应用。

Objective To study the safety and efficacy of ultrasound-guided percutaneous transhepatic gallbladder drainage（ PTGD） combined with scheduled laparoscopic cholecystectomy（ LC） in the treatment of acute severe cholecystitis. Methods Eighty-two patients with acute severe cholecystitis were collected in our hospital during April 2015 and April 2016,and were divided into the observation group（ n = 41） and the control group（ n = 41） according to the different surgical methods. The observation group received ultrasound-guided PTGD treatment,to which scheduled LC was added after 3 ~ 4 weeks. The control group received emergency LC. The treatment results were compared between the two groups. Results The operation time of the observation group was longer than that of the control group,and the intraoperative conversion rate of the observation group was higher than that of the control group（ P 0. 05）. The incidence of complications of the observation group was significantly lower than that of the control group（ P 0. 05）. Conclusion Ultrasound-guided PTGD combined with scheduled LC is safe and effective for the patients with acute severe cholecystitis,with advantages of less trauma,fewer complications and faster recovery.