PTGD序贯腹腔镜胆囊切除术在高危急性胆囊炎患者中的治疗作用

Abstract
Figure/Table
References (0)
Related Citation (5)

Download: PDF (2368 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To summarize the experience in the treatment of ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) sequential laparoscopic cholecystectomy (LC) in the elderly and high-risk patients with acute cholecystitis. Methods: The clinical data of 54 patients who underwent PTGD sequential LC between July 2013 and June 2016 were analyzed retrospectively. All the patients accepted LC after PTGD 1-2 weeks or 2-3 months determined by their family factors and physical status. Results: PTGD was successfully performed in all patients. Selective laparoscopic cholecystectomy was performed in 1-2 weeks or after 2-3 months. There was no significant difference between two groups in operative time, hospital stay, conversion to laparotomy and complications. Conclusion: PTGD is a safe, simple and effective procedure for treatment of elderly and high-risk patients with acute cholecystitis. If the patient’s conditions permit, early LC treatment was safe and feasible.

Key words： percutaneous transhepatic gallbladder drainage high-risk acute cholecystitis laparoscopic cholecystectomy

Received: 17 June 2017

	Service
	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	CHEN Hui
	ZHANG Xuming
	HONG Zhong
	ZHENG Peng
	XIE Junqing
	WANG Jisheng
	ZHOU Bin
	TONG Hongfei

URL:

https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2018/V48/I3/185

[1] MORSE B C, SMITH J B, LAWDAHL R B, et al. Management of acute cholecystitis in critically ill patients: contemporary role for cholecystostomy and subsequent cholecys-tectomy[J]. Am Surg, 2010, 76(7): 708-712.
[2] LOBERANT N, NOTES Y, EITAN A, et al. Comparison of early outcome from transperitoneal versus transhepatic percutaneous cholecystostomy[J]. Hepatogastroenterology, 2010, 57(97): 12-17.
[3] 贾宝兴, 谭璐东, 纪柏, 等. 经皮经肝胆囊穿刺引流联合腹腔镜胆囊切除治疗急性危重胆囊炎[J]. 中华肝胆外科杂志, 2014, 20(11): 802-804.
[4] 中华医学会外科学分会胆道外科学组. 急性胆道系统感染的诊断和治疗指南(2011版)[J]. 中华消化外科杂志, 2011, 10(1): 9-13.
[5] 王军, 金焰. 经皮经肝胆囊穿刺引流术在高龄、高危患者的应用[J]. 肝胆胰外科杂志, 2012, 24(1): 67-68.
[6] 吴晓英, 吴跃武, 吴颀, 等. 急性结石性胆囊炎腹腔镜手术时机选择的Meta分析[J]. 温州医科大学学报, 2015, 45(4): 304-309.
[7] HAFIF A, GUTMAN M, KAPLAN O, et al. The management of acute cholecystitis in elderly patients[J]. Am Surg, 1991, 57(10): 648-652.
[8] RADDER R W. Percutaneous cholecystostomy[J]. AJR Am J Roentgenol, 1982, 139(6): 1240-1241.
[9] TSENG L J, TSAI C C, MO L R, et al. Palliative percutaneous transhepatic gallbladder drainage of gallbladder empyema before laparoscopic cholecystectomy[J]. Hepatogastroenterology, 2000, 47(34): 932-936.
[10] WINBLADH A, GULLSTRAND P, SVANVIK J, et al. Systematic review of cholecystostomy as a treatment option in acute cholecystitis[J]. HPB (Oxford), 2009, 11(3): 183-193.
[11] AZIZ O, ASHRAFIAN H, JONES C, et al. Laparoscopic ultrasonography versus intra-operative cholangiogram for the detection of common bile duct stones during laparoscopic cholecystectomy: a meta-analysis of diagnostic accuracy[J]. Int J Surg, 2014, 12(7): 712-719.
[12] SIDDIQUI T, MACDONALD A, CHONG P S, et al. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials[J]. Am J Surg, 2008, 195(195): 40-47.
[13] KOLLA S B, AGGARWALl S, KUMAR A, et al. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial[J]. Surg Endosc, 2004, 18(9): 1323-1327.
[14] ABI-HAIDAR Y, SANCHEZ V, WILLIAMS S A, et al. Revisiting percutaneous cholecystostomy for acute cholecystitis based on a 10-year experience[J]. Arch Surg, 2012, 147 (147): 416-422.
[15] 胡逸人, 潘江华, 王奕, 等. PTGD与腹腔镜胆囊切除序贯微创治疗高危急性胆囊炎疗效分析[J]. 浙江医学, 2015, 34(6): 488-490.
[16] KIM I G, KIM J S, JEON J Y, et al. Percutaneous transhepatic gallbladder drainage changes emergency laparoscopic cholecystectomy to an elective operation in patients with acute cholecystitis[J]. J Laparoendosc Adv Surg Tech A, 2011, 21(10): 941-946.