LaBerge J M, Gordon R L, Kerlan R K, Ring E J
Department of Radiology, University of California, San Fransisco 94143-0628.
J Vasc Interv Radiol. 1991 Nov;2(4):539-41. doi: 10.1016/s1051-0443(91)72238-0.
Percutaneous cholecystostomy has become an accepted therapeutic alternative for high-risk patients with acute cholecystitis. However, some authors have cautioned that patients with gallbladder wall necrosis and gangrene may not be effectively treated by means of percutaneous drainage alone. A case is reported in which gallbladder wall necrosis progressed following technically successful percutaneous drainage. Spontaneous gallbladder rupture ensued, necessitating emergent cholecystectomy. Cholecystography 2 weeks following tube placement and 1 week prior to rupture showed a markedly abnormal, irregular gallbladder lumen. The authors suggest that follow-up cholecystography may be a useful tool for evaluating patient response to percutaneous cholecystostomy and for determining subsequent patient management.
经皮胆囊造瘘术已成为高危急性胆囊炎患者可接受的治疗选择。然而，一些作者警告说，胆囊壁坏死和坏疽的患者仅通过经皮引流可能无法得到有效治疗。本文报道了一例在技术上成功进行经皮引流后胆囊壁坏死仍进展的病例。随后发生了自发性胆囊破裂，需要紧急行胆囊切除术。置管后2周及破裂前1周的胆囊造影显示胆囊腔明显异常、不规则。作者认为，随访胆囊造影可能是评估患者对经皮胆囊造瘘术反应及确定后续患者管理的有用工具。
