Furlan F, Fugazzola C, Brunelli G, Franco F
I Servizio di Radiologia, Ospedale Maggiore di Borgo Trento, Verona.
Radiol Med. 1992 Sep;84(3):247-51.
The authors report on their personal experience with percutaneous cholecystostomy (PC) in 36 cases of acute cholecystitis (AC). PC was successful in 34 cases, improving the clinical condition of the patients within the first hour following treatment and normalizing the laboratory data within 24-48 hours. Twenty-seven patients with calculous AC underwent cholecystectomy within 4-15 days. In 6 cases (3 calculous and 3 acalculous ACs) PC was the only treatment performed; in one case (calculous AC) PC was combined with lithotomy, the stone fragments being extracted via the cholecystostomy. According to literature reports, to date PC has been performed mainly--as an alternative to surgical cholecystostomy--on the patients unsuitable for cholecystectomy due to their age or to severe impairment of their conditions. In our experience, the procedure can be performed on a wider range of patients as a final (notably in acalculous AC) or temporary step (notably in calculous AC where it may allow cholecystectomy to be delayed and thus performed under better clinical conditions, with decreased morbidity and mortality risks).
作者报告了他们对36例急性胆囊炎(AC)患者进行经皮胆囊造瘘术(PC)的个人经验。34例PC手术成功,治疗后1小时内患者临床状况改善,24 - 48小时内实验室数据恢复正常。27例结石性AC患者在4 - 15天内接受了胆囊切除术。6例患者(3例结石性AC和3例非结石性AC)仅接受了PC治疗;1例患者(结石性AC)PC联合取石术,通过胆囊造瘘口取出结石碎片。根据文献报道,迄今为止,PC主要作为外科胆囊造瘘术的替代方法,用于因年龄或病情严重而不适于胆囊切除术的患者。根据我们的经验,该手术可应用于更广泛的患者群体,作为最终治疗手段(尤其是在非结石性AC中)或临时措施(尤其是在结石性AC中,它可能使胆囊切除术得以延迟,从而在更好的临床条件下进行,降低发病率和死亡率风险)。