Frazee R C, Nagorney D M, Mucha P
Department of Surgery, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1989 Feb;64(2):163-7. doi: 10.1016/s0025-6196(12)65670-5.
Acute acalculous cholecystitis occurs infrequently, but the incidence seems to be increasing. Its attendant high associated morbidity and mortality dictate prompt diagnosis. Diagnosing this condition is often difficult because of the patient's debilitated medical condition and the limitations of biliary imaging techniques. During a 5-year study period (1981 through 1986), 20 patients underwent assessment and treatment for acute acalculous cholecystitis at our institution. This observation suggests an increase in incidence in comparison with a previously reported review of 28 such patients during a 16-year period at our institution. Initial treatment consisted of cholecystectomy in 18 patients, and percutaneous transhepatic cholecystostomy was successfully used in the other 2 patients. The postoperative mortality and morbidity for these 20 patients were 30% and 55%, respectively. Percutaneous transhepatic cholecystostomy should be explored further as a treatment option for acute acalculous cholecystitis.
急性非结石性胆囊炎发病率较低，但似乎呈上升趋势。其伴随的高发病率和死亡率要求及时诊断。由于患者身体状况不佳以及胆道成像技术的局限性，诊断这种疾病往往很困难。在一个5年研究期（1981年至1986年）内，我院有20例患者接受了急性非结石性胆囊炎的评估和治疗。这一观察结果表明，与我院此前报道的16年期间28例此类患者的回顾性研究相比，发病率有所上升。初始治疗包括18例患者行胆囊切除术，另外2例患者成功接受了经皮经肝胆囊造瘘术。这20例患者的术后死亡率和发病率分别为30%和55%。经皮经肝胆囊造瘘术作为急性非结石性胆囊炎的一种治疗选择应进一步探索。
