Langlois P, Bousquet J C, Bodin L, Rouby J J, Chigot J P
Presse Med. 1985;14(28):1501-3.
During the last 8 years 51 cases of acute post-traumatic or post-operative cholecystitis were observed in our intensive care unit. Twelve patients benefited from ultrasonically guided percutaneous cholecystostomy under television control. Diagnosis was made by ultrasonic examination and was based on the finding of an enlarged and tender gallbladder with an abnormally thick wall, sometimes with a double wall, and on the presence of sludge. Immediate cholangiography revealed spontaneous perforation in 4 patients who were operated upon at once. The other patients were treated by percutaneous cholecystostomy only with apparent success. The frequency, physiopathology, diagnosis and treatment of acute post-aggressive cholecystitis are discussed, with special reference to this new therapeutic approach.
在过去8年里，我们的重症监护病房观察到51例急性创伤后或术后胆囊炎病例。12例患者在电视控制下接受了超声引导下经皮胆囊造瘘术，从中受益。诊断通过超声检查做出，依据是发现胆囊增大且有触痛，胆囊壁异常增厚，有时呈双层壁，以及存在胆泥。即时胆管造影显示4例患者出现自发性穿孔，这些患者立即接受了手术。其他患者仅接受经皮胆囊造瘘术治疗，效果明显。本文讨论了急性侵袭后胆囊炎的发生率、病理生理学、诊断和治疗，并特别提及了这种新的治疗方法。
