PTGD续贯LC和急诊LC治疗老年GradeⅡ级急性胆囊炎疗效比较

目的比较经皮经肝胆囊穿刺引流术后续贯行腹腔镜下胆囊切除术(PTGD+LC)和急诊腹腔镜下胆囊切除术(LC)治疗>65岁老年性Grade I级急性胆囊炎(AC)的疗效。方法收集2016年6月至2019年6月经PTGD+LC和急诊LC治疗符合TG13诊断标准的Grade I级AC(年龄>65岁)96例患者的临床资料,其中PTGD+LC组37例,急诊LC组59例。结果PTGD+LC组与急诊LC组比较:手术时间短(56±12min vs 88±16min,P<0.05),术中出血量少(52.6±23.3ml vs 73.5±25.6ml,P<0.05),术后肛门排气时间早(23.5±5.7h vs 26.5±5.9h,P<0.05)、术后住院时间短(4.3±1.5dvs 6.6±1.7d,P<0.05)、术后并发症少(4例vs 17例,P<0.05)。结论>65岁老年性Grnade I级AC患者PTGD术后续贯行LC,不仅患者缩短术后住院时间,还能降低手术相关并发症的发生,提高患者的生活质量。

Objective To compare the efiacy of percutaneous transhepatic cholecystectomy(PTGD+LC)and emergency laparoscopic cholecystectomy(LC)in the treatment of gradeⅡacute cholcystitis(AC)in the aged over 65.Methods A retrospective case sudy of patients with GradeⅡAC(age>65 years)who met TG13 diagnostic citeria was conducted from June 2016 to June 2019,including 37 cases in PTGD+LC group and 59 cases in emergency LC group.Results Comparison of PTGD+LC group with emergency LC group:shorter operation time(56±12min vs 88±16min,P=0.000<0.05),less intraoperative bleeding(52.6±23.3ml vs 73.5±25.6ml,P=0.000<0.05),earlyer postoperative anal exhaust time(23.5±5.7h vs 26.5±5.9h,P=0.016<0.05),shorter postoperative hospitalization time(4.3±1.5d vs 6.6±1.7d,P=0.000<0.05),fewer cases of postoperative complications(4vs 17,P=0.038<0.05).Conclusion The follow-up of PTGD in patients over 65 years with GradeⅡAC annot only shorten the postoperative hospialization time,but also reduce the ocurrence of surgial complcations and improve the quality of life of patiens.