Bundy Jacob, Srinivasa Ravi N, Gemmete Joseph J, Shields James J, Chick Jeffrey Forris Beecham
Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.
Cardiovasc Intervent Radiol. 2018 Jun;41(6):928-934. doi: 10.1007/s00270-018-1884-5. Epub 2018 Jan 29.
To report technical success and clinical outcome of cholecystostomy tube placement along with timing-and method-of tube removal.
A retrospective review of cholecystostomy tubes placed from January 2010 to September 2017 was performed at a single academic center. This search yielded 1160 patients. Of these patients, 324 (27.9%) met inclusion criteria for cholecystostomy placement, 199 (61.4%) males and 125 (38.6%) females, with mean age of 67 years (range 6-101 years). The indication for cholecystostomy tube placement, technical success, surgical candidacy, medical comorbidities, clinical outcome, tube indwelling time, complications, and follow-up were recorded.
Indications for cholecystostomy tube placement included: acute cholecystitis (n = 270; 83.3%), perforated cholecystitis (n = 22; 6.8%), emphysematous cholecystitis (n = 18; 5.6%), and other (n = 14; 4.3%). Technical success was 100%. Many patients had multiple medical comorbidities including (most commonly): debilitation (n = 211; 65.1%), cardiovascular disease (n = 194; 59.9%), multisystem disease (n = 181; 55.9%), and malignancy (n = 131; 40.4%). After tube placement, 96 (29.6%) patients underwent definitive cholecystectomy, 94 expired (29.0%), 36 (11.1%) had a patent cystic duct on follow-up cholangiogram and subsequent cholecystostomy removal, 14 (4.3%) underwent cholecystoscopy with stone removal, and 3 (0.9%) had liver transplantation. Forty-five (13.9%) patients had indwelling tubes at the end of the study period. Mean tube indwelling time was 89 days (range 0-586 days).
Technical success for cholecystostomy tube placement was 100% with all patients having clinical resolution of acute cholecystitis. Many patients were able to have tubes subsequently removed.
报告胆囊造瘘管置入术的技术成功率、临床结局以及拔管时机和方法。
对2010年1月至2017年9月在单一学术中心置入胆囊造瘘管的情况进行回顾性研究。此次检索共纳入1160例患者。其中，324例（27.9%）符合胆囊造瘘管置入的纳入标准，男性199例（61.4%），女性125例（38.6%），平均年龄67岁（范围6 - 101岁）。记录胆囊造瘘管置入的指征、技术成功率、手术候选资格、合并症、临床结局、置管时间、并发症及随访情况。
胆囊造瘘管置入的指征包括：急性胆囊炎（n = 270；83.3%）、穿孔性胆囊炎（n = 22；6.8%）、气肿性胆囊炎（n = 18；5.6%）及其他（n = 14；4.3%）。技术成功率为100%。许多患者合并多种疾病，最常见的有：身体虚弱（n = 211；65.1%）、心血管疾病（n = 194；59.9%）、多系统疾病（n = 181；55.9%）及恶性肿瘤（n = 131；40.4%）。置管后，96例（29.6%）患者接受了确定性胆囊切除术，94例（29.0%）死亡，36例（11.1%）在随访胆管造影时发现胆囊管通畅并随后拔除胆囊造瘘管，14例（4.3%）接受了胆囊镜取石术，3例（0.9%）接受了肝移植。45例（13.9%）患者在研究期末仍留置造瘘管。平均置管时间为89天（范围0 - 586天）。
胆囊造瘘管置入术的技术成功率为100%，所有患者的急性胆囊炎均获得临床缓解。许多患者随后能够拔除造瘘管。
