Karakas Hakki Muammer, Yildirim Gulsah, Fersahoglu Mehmet Mahir, Findik Ozge
Department of Radiology, University of Health Sciences, Istanbul Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Department of General Surgery, University of Health Sciences, Istanbul Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
North Clin Istanb. 2021 Oct 6;8(5):537-542. doi: 10.14744/nci.2021.81594. eCollection 2021.
Cholecystectomy is the standard treatment of acute cholecystitis. Surgery, however, poses significant risks for patients with advanced age and/or comorbid conditions. For such patients, percutaneous cholecystostomy (PC) is the only option. This interventional procedure does not have any absolute contraindications because of the life-threatening nature of the disease, in which other treatment options cannot be offered due to their risks. Nonetheless, these risk factors necessitate performing PC under urgent, rapid, and in many cases suboptimal conditions. In this article, PC was revisited in the light of our extensive experience in addition to the most current literature. Pre-procedural evaluation including the risk assessment and procedural steps was presented in detail. If conducted properly, PC provides significant clinical improvement in the short term and is life-saving, especially in the elderly and in patients with comorbid diseases or high surgical risk. It may also be the definitive treatment method for acute cholecystitis.
胆囊切除术是急性胆囊炎的标准治疗方法。然而，手术对于高龄和/或患有合并症的患者具有重大风险。对于此类患者，经皮胆囊造瘘术（PC）是唯一的选择。由于该疾病危及生命，其他治疗选择因风险过高而无法提供，因此这种介入手术没有任何绝对禁忌症。尽管如此，这些风险因素使得PC必须在紧急、快速且在许多情况下并不理想的条件下进行。在本文中，除了最新的文献资料外，还结合我们丰富的经验对PC进行了重新审视。详细介绍了包括风险评估和操作步骤在内的术前评估。如果操作得当，PC可在短期内带来显著的临床改善，并且挽救生命，尤其是对于老年人以及患有合并症或手术风险高的患者。它也可能是急性胆囊炎的确定性治疗方法。
