Marchal F, Bresler L, Tortuyaux J M, Boissel P, Deneuville M, Régent D
Service de Chirurgie Digestive, Centre Hospitalier de Nancy, Hôpitaux de Brabois, Vandoeuvre-Les-Nancy.
Ann Chir. 1998;52(7):618-24.
Surgery is the treatment of acute calculous cholecystitis. Mortality and morbidity are considerable for patients with anesthetic risk factors. In this context, ultrasound-guided percutaneous drainage seems to be a alternative to urgent surgery. The place of this technic and its results have not been determined with certainty. We report our experience of percutaneous drainage in acute calculous cholecystitis, based on a series of 27 patients treated between May 1992 and May 1996. A favorable course was observed after drainage in 26 patients, one patient was operated urgently for purulent peritonitis on D1. One drain migrated into the gallbladder and required cholecystenterostomy en D30. Seventeen patients underwent cholecystectomy after the acute episode. Surgery was contra-indicated in light patients: two presented recurrence of acute calculous cholecystitis and six remained asymptomatic. The aim of this study was to define the place of this technic in the treatment of acute calculous cholecystitis, and estimate the results in terms of mortality, morbidity and recurrence.
手术是治疗急性结石性胆囊炎的方法。对于有麻醉风险因素的患者，死亡率和发病率相当高。在这种情况下，超声引导下经皮引流似乎是紧急手术的一种替代方法。这种技术的地位及其结果尚未确定。我们报告了我们在急性结石性胆囊炎经皮引流方面的经验，基于1992年5月至1996年5月期间治疗的一系列27例患者。26例患者引流后病情好转，1例患者在第1天因化脓性腹膜炎紧急手术。1根引流管移入胆囊，在第30天需要进行胆囊肠吻合术。17例患者在急性发作后接受了胆囊切除术。轻症患者手术禁忌：2例出现急性结石性胆囊炎复发，6例无症状。本研究的目的是确定这种技术在急性结石性胆囊炎治疗中的地位，并评估其在死亡率、发病率和复发率方面的结果。
