Eggermont A M, Laméris J S, Jeekel J
Arch Surg. 1985 Dec;120(12):1354-6. doi: 10.1001/archsurg.1985.01390360020005.
Ultrasound-guided percutaneous transhepatic cholecystostomy was performed in six critically ill patients who had acute acalculous cholecystitis. The clinical conditions of all six patients improved dramatically following transhepatic cholecystostomy. No complications of this bedside procedure occurred. Cholangiography via the inserted pigtail catheter was normal in four patients. Their catheters were removed after ten to 21 days. At follow-up examinations at four to 30 months they were free of signs of gallbladder disease. In one patient, ultrasonography showed desquamation of the mucosa in the gallbladder, which led to the decision to perform cholecystectomy two days after cholecystostomy. One patient, suffering from cholangiocarcinoma, died 120 days after cholecystostomy with the catheter in situ. In our experience, ultrasound-guided percutaneous transhepatic cholecystostomy is the treatment of choice to overcome a critical period in patients with acute acalculous cholecystitis. When post-drainage cholangiography is normal, cholecystectomy at a later stage is not indicated in the majority of these patients.
对6例患有急性非结石性胆囊炎的重症患者实施了超声引导下经皮经肝胆囊造瘘术。经肝胆囊造瘘术后，所有6例患者的临床状况均显著改善。该床边操作未出现并发症。通过插入的猪尾导管进行的胆管造影在4例患者中结果正常。他们的导管在10至21天后拔除。在4至30个月的随访检查中，他们没有胆囊疾病的迹象。1例患者超声检查显示胆囊黏膜剥脱，这导致在胆囊造瘘术后两天决定实施胆囊切除术。1例患有胆管癌的患者在胆囊造瘘术后120天，导管仍留置时死亡。根据我们的经验，超声引导下经皮经肝胆囊造瘘术是治疗急性非结石性胆囊炎患者关键时期的首选治疗方法。当引流后胆管造影正常时，大多数此类患者后期无需进行胆囊切除术。
