Stage J G, Rasmussen S G, Damgaard B, Kehlet H
Hvidovre Hospital, Kirurgisk gastroenterologisk afdeling, København.
Ugeskr Laeger. 1991 Nov 11;153(46):3231-3.
Thirty-two high-risk patients with severe complicating conditions and gall bladder symptoms requiring treatment, including acute cholecystitis in 28 of the patients, were treated with percutaneous cholecystolithotripsy (PTCL). This intervention was carried out under general, regional or local anaesthesia and resulted in fragmentation and removal of the stones in 90% of the patients. Cholecystectomy proved necessary in three patients on account of perforation in two and formation of "steinstrasse" in the cystic duct in one. No other complications of puncture or lithotripsy occurred and the postlithotripsy drainage time was, on the average, ten days. It is concluded that the PTCL technique is a realistic therapeutic offer to high-risk patients with gall bladder stones requiring treatment and in whom laparoscopic cholecystectomy or mini-cholecystectomy are not considered suitable.
32例伴有严重并发症且有胆囊症状需要治疗的高危患者接受了经皮胆囊碎石术(PTCL),其中28例为急性胆囊炎。该手术在全身麻醉、区域麻醉或局部麻醉下进行,90%的患者结石被击碎并清除。2例患者因胆囊穿孔、1例患者因胆囊管内形成“铸型结石”而不得不进行胆囊切除术。未发生其他穿刺或碎石并发症,碎石术后平均引流时间为10天。得出的结论是,PTCL技术为需要治疗且不适合行腹腔镜胆囊切除术或小切口胆囊切除术的高危胆囊结石患者提供了一种切实可行的治疗方法。