vanSonnenberg E, D'Agostino H B, Casola G, Hoyt D B, Lurie A, Varney R R
Department of Radiology, University of California, San Diego 92103.
Radiology. 1991 Mar;178(3):687-9. doi: 10.1148/radiology.178.3.1994403.
Three patients with spontaneous gallbladder perforation and one with an iatrogenic bile leak causing bile peritonitis were treated successfully by means of percutaneous catheter drainage. Three patients had cholelithiasis as the cause of perforation; the fourth patient had previously undergone gallstone dissolution with methyl tert-butyl ether lavage and developed bile peritonitis a few hours after removal of the catheter. In three patients, a percutaneous cholecystostomy catheter provided successful decompression; in the fourth patient, drainage was performed with a percutaneous sump catheter in the subhepatic space adjacent to the gallbladder. No specific complications occurred. Follow-up was performed at 1, 12, 22, and 59 months, respectively. To date, one of the four patients has undergone elective cholecystectomy (1 month after drainage). The remainder of the patients are asymptomatic. This preliminary experience suggests that the severe complication of gallbladder perforation and bile leakage may be treated, at least temporarily, by means of percutaneous drainage.
三名自发性胆囊穿孔患者和一名因医源性胆漏导致胆汁性腹膜炎的患者通过经皮导管引流成功治愈。三名患者因胆石症导致穿孔；第四名患者此前接受了甲基叔丁基醚灌洗溶石治疗，并在拔除导管后数小时发生胆汁性腹膜炎。三名患者通过经皮胆囊造瘘导管成功减压；第四名患者在胆囊旁的肝下间隙用经皮引流管进行引流。未发生特定并发症。分别在1个月、12个月、22个月和59个月进行了随访。迄今为止，四名患者中有一名已接受择期胆囊切除术（引流后1个月）。其余患者无症状。这一初步经验表明，胆囊穿孔和胆漏的严重并发症至少可通过经皮引流得到临时治疗。
