Cope C
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
AJR Am J Roentgenol. 1988 Dec;151(6):1129-32. doi: 10.2214/ajr.151.6.1129.
Percutaneous subhepatic cholecystostomy is preferable to the transhepatic technique because it spares the liver from unnecessary trauma and possible sepsis. In order to prevent gallbladder wall invagination and intraperitoneal bile leakage, the fundus is first secured to the abdominal wall with a removable anchoring device that is introduced through a 17-gauge needle system under sonographic and fluoroscopic control. With this technique, the gallbladder was drained in seven patients with possible empyema, and stones were extracted from the gallbladder in three patients who were poor risks for cholecystectomy. None of the patients had hypotension, bile leakage, peritonitis, or bleeding. Subhepatic cholecystostomy was done safely in 10 patients after temporarily anchoring the fundus to the abdominal wall.
经皮肝下胆囊造瘘术优于经肝技术，因为它可使肝脏免受不必要的创伤和可能的感染。为防止胆囊壁内陷和腹腔胆汁漏，首先用可移除的锚定装置将胆囊底部固定于腹壁，该装置通过17号针系统在超声和荧光透视引导下置入。采用该技术，7例可能患有积脓的患者的胆囊得以引流，3例胆囊切除术风险较高的患者从胆囊中取出了结石。所有患者均未出现低血压、胆汁漏、腹膜炎或出血。在将胆囊底部临时固定于腹壁后，10例患者安全地完成了肝下胆囊造瘘术。
