Berger H, Forst H, Nattermann U, Pratschke E
Radiologische Klinik und Poliklinik, Universität München, Klinikum Grosshadern.
Rofo. 1989 Jun;150(6):694-8. doi: 10.1055/s-2008-1047104.
Percutaneous cholecystostomy was performed in 17 poor surgical risk patients. 16 patients developed acute acalculous cholecystitis postoperatively in the intensive care unit, 1 patient had an acute cholecystitis with calculi. Diagnostic imaging using CT and US was specific for acute cholecystitis in 58% only. Percutaneous cholecystostomy was the definitive treatment in 69% of the patients. Additional cholecystectomy was required in 3 patients with complicated cholecystitis, in 1 patient with bile leakage after catheter dislocation and in 1 patient with gallbladder calculi. 3 patients died, 2 of them from reasons unrelated to the gallbladder disease. Radiology-guided percutaneous cholecystostomy performed by a transhepatic approach is a safe and effective procedure for acute cholecystitis in high-risk patients.
对17例手术风险高的患者实施了经皮胆囊造瘘术。16例患者在重症监护病房术后发生急性非结石性胆囊炎,1例患者患有结石性急性胆囊炎。仅58%的患者通过CT和超声进行的诊断性成像对急性胆囊炎具有特异性。经皮胆囊造瘘术是69%患者的确定性治疗方法。3例复杂性胆囊炎患者、1例导管移位后胆汁漏患者和1例胆囊结石患者需要额外进行胆囊切除术。3例患者死亡,其中2例死亡原因与胆囊疾病无关。经肝途径由放射科医生引导进行的经皮胆囊造瘘术是高危患者急性胆囊炎的一种安全有效的手术。