Werbel G B, Nahrwold D L, Joehl R J, Vogelzang R L, Rege R V
Department of Surgery, Northwestern University Medical School, Chicago, IL 60611.
Arch Surg. 1989 Jul;124(7):782-5; discussion 785-6. doi: 10.1001/archsurg.1989.01410070032007.
We performed percutaneous cholecystostomy in 22 critically ill patients with suspected acute cholecystitis. This procedure accurately diagnosed acute cholecystitis in 17 of these 22 patients and excluded the diagnosis in the other 5 patients. Moreover, percutaneous cholecystostomy stabilized the conditions of 16 of the 17 patients with acute cholecystitis, allowing elective surgery in 8 patients and effectively treating 8 patients who never became surgical candidates. Percutaneous cholecystostomy and bile cultures are useful in the diagnosis and treatment of acute cholecystitis and should be performed in critically ill patients with clinical, laboratory, and radiologic evidence of acute cholecystitis and an excessive risk for cholecystectomy.
我们对22例疑似急性胆囊炎的重症患者实施了经皮胆囊造瘘术。该操作准确诊断出这22例患者中的17例患有急性胆囊炎，排除了另外5例患者的该诊断。此外，经皮胆囊造瘘术使17例急性胆囊炎患者中的16例病情稳定，其中8例患者得以接受择期手术，另有8例患者从未成为手术候选对象但得到了有效治疗。经皮胆囊造瘘术和胆汁培养对急性胆囊炎的诊断和治疗有用，对于有急性胆囊炎临床、实验室及影像学证据且胆囊切除术风险过高的重症患者应实施该操作。
