介入超声联合胆道镜双通道“一步法”治疗高龄急性结石性胆囊炎的疗效观察

Double channel "one-step" of interventional ultrasound combined with choledochoscopy in the treatment of senile acute calculous cholecystitis

目的探讨介入超声联合胆道镜双通道“一步法”治疗高龄高危急性结石性胆囊炎的临床可行性。方法回顾性分析2016年6月至2018年7月于西部战区总医院就诊并接受该技术治疗的54例患者临床资料。结果54例患者均成功完成双通道置管(超声引导下经皮经肝胆囊穿刺,同期行胆道镜取石)。其中50例患者取石成功,成功率为93%;并发症方面,1例出血,1例术后超声复查疑似胆漏。50例患者随访3~12个月,1例结石复发。结论超声引导下经皮经肝胆囊穿刺同期胆道镜取石这种双通道“一步法”治疗高龄高危急性结石性胆囊炎安全有效,具有临床可行性。

Objective To investigate the feasibility and clinical value of double channel"one-step"of interventional ultrasound combined with choledochoscopy in the treatment of senile acute calculous cholecystitis.Methods The clinical data of 54 patients with senile acute calculous cholecystitis admitted in General Hospital of Western Theater Command from Jun.2016 to Jul.2018 were retrospectively analyzed.Results All the 54 patients successfully completed the double channel"one-step"protocol,underwent ultrasound guided percutaneous transhepatic cholecystectomy,meanwhile underwent choledochoscopic lithotomy.Successful stone removal in 50 patients(93%).In terms of postoperative complications,hemorrhage found in 1 case had,and suspected bile leakage found in 1 case by postoperative ultrasound check.50 patients were followed-up for 3 to 12 months,stone recurrence found in 1 case.Conclusion Double channel"one-step"of ultrasound guided percutaneous transhepatic cholecystectomy combined with choledochoscopic lithotomy in the treatment of senile acute calculous cholecystitis is safe and effective,with clinical application value.