Joly J P, Duchmann J C, el Yamani A, Yzet T, Delcenserie R, Dupas J L, Capron J P
Service d'Hépato-Gastroentèrologie, CHU Nord, Amiens.
Gastroenterol Clin Biol. 1998 Feb;22(2):127-31.
The treatment of acute cholecystitis or angiocholitis is often difficult in elderly or very ill patients. The aim of this retrospective study was to assess the efficacy and the results of ultrasound guided percutaneous cholecystostomy in patients with acute cholecystitis or biliary tract obstruction and anesthetic or surgical contraindications.
Thirty patients (25-93 years, 16 men and 14 women) were included in this study. Ultrasound guided percutaneous cholecystostomy was successful on the septic syndrome in 27 patients; endoscopic sphincterotomy was performed in 6 patients after clinical improvement. A failure of the procedure on sepsis was observed in 3 patients: cholecystectomy was performed after cardiac improvement in one patient, and 2 patients died. Two other patients died of extradigestive diseases. No serious complication related to cholecystostomy was observed.
Ultrasound guided percutaneous cholecystostomy is a safe and simple procedure. It can be done at bedside and has low morbidity and mortality. It can be considered as a definitive treatment, or a temporary one with secondary surgical or endoscopic management.
对于老年患者或病情严重的患者,急性胆囊炎或胆管炎的治疗往往颇具难度。本回顾性研究旨在评估超声引导下经皮胆囊造瘘术对患有急性胆囊炎或胆道梗阻且存在麻醉或手术禁忌证患者的疗效及结果。
本研究纳入了30例患者(年龄25 - 93岁,男性16例,女性14例)。超声引导下经皮胆囊造瘘术使27例患者的脓毒症得到成功治疗;6例患者在临床症状改善后接受了内镜括约肌切开术。3例患者的脓毒症治疗失败:1例患者在心脏功能改善后接受了胆囊切除术,2例患者死亡。另外2例患者死于消化系统外疾病。未观察到与胆囊造瘘术相关的严重并发症。
超声引导下经皮胆囊造瘘术是一种安全、简单的手术。可在床边进行,发病率和死亡率低。可将其视为确定性治疗方法,或作为后续手术或内镜治疗的临时性治疗方法。