Takada T, Yasuda H, Uchiyama K, Hasegawa H, Asagoe T, Shikata J
First Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Radiology. 1989 Sep;172(3):693-7. doi: 10.1148/radiology.172.3.2672094.
Sixteen patients with a pericholecystic abscess were classified into three groups according to the sonographic findings: Nine patients had an abscess in the gallbladder bed, three in an intramural location in the gallbladder, and four in an intraperitoneal cavity. In the gallbladder bed group, six patients with a localized abscess responded well to conservative therapy, followed by an elective operation. Two patients with a complicated abscess were initially treated with ultrasonically (US) guided percutaneous transhepatic gallbladder drainage and then with percutaneous transhepatic aspiration of the liver abscess, followed by an elective operation. A patient with a communicating abscess underwent an elective operation because the abscess completely disappeared after percutaneous transhepatic abscess drainage under US guidance. One of the three patients with an intramural abscess needed an immediate operation, and the other two were treated conservatively, followed by an elective operation. All four patients with an intraperitoneal abscess needed an emergency operation. Because each type of abscess received differing and successful treatments, the authors' method of classification of US findings seemed to provide a useful way to select the specific therapeutic procedure to achieve optimal results.
16例胆囊周围脓肿患者根据超声检查结果分为三组：9例脓肿位于胆囊床，3例位于胆囊壁内，4例位于腹腔内。在胆囊床组中，6例局限性脓肿患者对保守治疗反应良好，随后接受择期手术。2例复杂性脓肿患者最初接受超声引导下经皮经肝胆囊引流，然后经皮经肝穿刺抽吸肝脓肿，随后接受择期手术。1例交通性脓肿患者接受了择期手术，因为在超声引导下经皮经肝脓肿引流后脓肿完全消失。3例壁内脓肿患者中有1例需要立即手术，另外2例接受保守治疗，随后接受择期手术。所有4例腹腔脓肿患者均需要急诊手术。由于每种类型的脓肿都接受了不同且成功的治疗，作者的超声检查结果分类方法似乎为选择特定的治疗方法以获得最佳效果提供了一种有用的方法。
