Hamy A, Visset J, Likholatnikov D, Lerat F, Gibaud H, Savigny B, Paineau J
Department of Surgery, University Hospital, Nantes, France.
Surgery. 1997 Apr;121(4):398-401. doi: 10.1016/s0039-6060(97)90309-3.
Cholecystectomy remains the best treatment for acute cholecystitis but may cause high morbidity or mortality in critically ill or elderly patients.
We report a retrospective study of ultrasonography-guided percutaneous cholecystostomy (USGPC) performed between 1988 and 1994 in 41 patients (mean age, 77.8 years; range, 42-95 years) as an alternative to surgery.
Five patients (12.2%) died in the hospital, four (9.8%) subsequently underwent operation without complications, six (15%) had a recurrence of cholecystitis between 3 and 24 months after withdrawal of drainage, and 26 patients are cured without recurrence after a mean follow-up of 33 months (range, 3-67 months).
USGPC appears to be the treatment of choice for high-risk patients, especially those with postoperative cholecystitis, severe acute calculous pancreatitis, or total parenteral nutrition.
胆囊切除术仍是急性胆囊炎的最佳治疗方法，但在重症患者或老年患者中可能导致高发病率或死亡率。
我们报告一项回顾性研究，该研究对1988年至1994年间41例患者（平均年龄77.8岁；范围42 - 95岁）进行了超声引导下经皮胆囊造瘘术（USGPC），作为手术的替代方法。
5例患者（12.2%）在医院死亡，4例（9.8%）随后接受手术且无并发症，6例（15%）在拔除引流管后3至24个月内胆囊炎复发，26例患者在平均随访33个月（范围3 - 67个月）后治愈且无复发。
USGPC似乎是高危患者的首选治疗方法，尤其是那些患有术后胆囊炎、重症急性结石性胰腺炎或全胃肠外营养的患者。
