Tian Ming Guo, Yang Li Ling
Department of Hepatobiliary Surgery, the People's Hospital of Ningxia Autonomous Region, Yinchuan, Ningxia, China.
Surg Laparosc Endosc Percutan Tech. 2014 Apr;24(2):e51-4. doi: 10.1097/SLE.0b013e31828f7033.
To investigate the feasibility of endoscopic ablation of the gallbladder mucosa after cholecystostomy.
The mucosa of the gallbladder was endoscopically electrocoagulated through the cholecystostomy tract. After ablation, repeated luminal irrigation with chymotrypsin solution was given before removal of the tube. The patients were followed up by ultrasonography after the procedure.
Twenty patients accepted this operation. The mean operating time was 38 minutes (range, 25 to 55 min). There were no procedure-related mortality and complications including perforation, bleeding, and cholangitis. Eighteen gallbladders have completely obliterated in 3 months. The other 2 gallbladders developed asymptomatic retention cysts. During 48 months of follow-up period, no stone occurred and no signs of malignancy were found at the site of the gallbladder. Seven patients died from the other medical illness.
Resectoscopic ablation of the gallbladder mucosa is a safe and promising approach to sclerosis of the gallbladder after cholecystostomy.
探讨胆囊造口术后内镜下消融胆囊黏膜的可行性。
通过胆囊造口通道在内镜下对胆囊黏膜进行电凝。消融后,在拔管前用糜蛋白酶溶液反复进行腔内冲洗。术后对患者进行超声随访。
20例患者接受了该手术。平均手术时间为38分钟(范围25至55分钟)。无与手术相关的死亡病例,也无包括穿孔、出血和胆管炎在内的并发症。18个胆囊在3个月内完全闭塞。另外2个胆囊形成无症状潴留囊肿。在48个月的随访期内,未出现结石,胆囊部位未发现恶性征象。7例患者死于其他疾病。
经内镜切除胆囊黏膜是胆囊造口术后胆囊硬化的一种安全且有前景的方法。