摘要
目的探讨超声引导下经皮经肝胆囊穿刺引流(PTGCD)治疗老年急性胆囊炎的策略及临床疗效。方法 38例有急诊胆囊切除禁忌的老年急性胆囊炎患者,在超声引导下行PTGCD。结果均一次性置管成功,未出现并发症;20例结石性胆囊炎患者择期行腹腔镜胆囊切除术,2例不能耐受手术行胆道镜将胆囊内结石取出;胆总管结石的5例,3例在腹腔镜胆囊切除术的同时行术中胆总管切开+胆道镜取石+T管引流术,2例腹腔镜胆囊切除术后14 d接受内镜下十二指肠乳头切开术取石。11例非结石性胆囊炎患者于引流后4周行胆道造影示无梗阻后拔管康复。结论对于老年急性胆囊炎患者,经皮经肝胆囊穿刺引流术操作简单、安全,疗效确切,具有重要临床应用价值。
【Objective】To discuss the therapeutic strategy and the clinical efficacy of percutaneous transhepatic gallbladder catheterizing drainage（PTGCD） guided by ultrasound for acute severe cholecystitis in senile patients.【Methods】38 old patients who were diagnosed acute severe cholecystitis with contraindications to cholecystectomy under-went PTGCD guided by ultrasound. 【Results】In all cases, the successful rate of PTGCD was 100% and no severe complication was taken place. In 20 patients accepted gallbladder resection in selective time after PTGCD,and the other 2 patients can＇t tolerate biliary mirror will do surgery in the gallbladder removed stone. Common bile duct stones in 5 patients, and 3 cases of laparoscopic cholecystectomy in at the same time do intraoperatie bravery manager, bile duct mirror cut stone, take t-tube drainage, 2 cases of laparoscopic cholecystectomy 14 days to accept after endoscopic incision duodenal nipple take stone. In 11 acalculous cases, the catheters were removed in 4weeks for no biliary obstruction was certified under cholangiography. 【Conclusions】Percutaneous cholecystostomy is a simple, safe and effective treatment for acute cholecystitis in high-risk patients. This technique is of great value in clinical practice.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2014年第24期86-88,共3页
China Journal of Modern Medicine
关键词
急性胆囊炎
经皮经肝胆囊穿刺引流
老年人
acute cholecystitis percutaneous transhepatic gallbladder catheterizing drainage senile
