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经皮胆囊造瘘术能否作为高危患者急性胆囊炎的确定性治疗方法?

Can percutaneous cholecystostomy be a definitive management for acute cholecystitis in high-risk patients?

作者信息

Zerem Enver, Omerović Safet

机构信息

*Department of Gastroenterology, University Clinical Center Tuzla, Tuzla †Department of Surgery, General Hospital Mostar, Mostar, Bosnia and Herzegovina.

出版信息

Surg Laparosc Endosc Percutan Tech. 2014 Apr;24(2):187-91. doi: 10.1097/SLE.0b013e31828fa45e.

Abstract

PURPOSE

To evaluate the efficacy, long-term outcome, and safety of percutaneous cholecystostomy (PC) in high-risk surgical patients.

METHODS

This was a retrospective descriptive review of the medical records of 36 patients who underwent PC for acute cholecystitis (AC) at a single institution between 2000 and 2011. Primary outcomes were overall morbidity, mortality, and need for interval cholecystectomy.

RESULTS

PC was initially successful, and symptoms disappeared within 3 days in all patients. Seven patients (2 during hospitalization and 5 during follow-up) died, 6 for a reason unrelated to AC, and 1 succumbed to a sepsis-related condition caused by uncontrolled cholecystitis progression. Elective cholecystectomy was performed in 6 patients. PC was a definitive treatment in 63.9% of patients.

CONCLUSIONS

PC is a safe and efficient treatment option for patients with AC who are less eligible for surgery. After patients recover from PC, further treatment such as cholecystectomy may not be needed.

摘要

目的

评估经皮胆囊造瘘术(PC)在高危手术患者中的疗效、长期预后及安全性。

方法

这是一项对2000年至2011年期间在单一机构接受PC治疗急性胆囊炎(AC)的36例患者病历的回顾性描述性研究。主要结局指标为总体发病率、死亡率及间隔期胆囊切除术的需求。

结果

PC最初成功,所有患者症状在3天内消失。7例患者死亡(2例在住院期间,5例在随访期间),6例死亡原因与AC无关,1例死于因胆囊炎进展失控导致的败血症相关疾病。6例患者接受了择期胆囊切除术。PC对63.9%的患者是一种确定性治疗。

结论

PC对于手术适应证较差的AC患者是一种安全有效的治疗选择。患者从PC恢复后,可能无需进一步治疗,如胆囊切除术。

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