| 摘要: |
| 目的 探讨经皮经肝胆囊穿刺引流术（PTGD）与腹腔镜胆囊切除（LC）序贯微创治疗高危急性胆囊炎（AC）的疗效。方法 对76 例高危AC患者根据就诊时患者全身状况、心肺功能及胆囊B 超检查结果，分别采用PTGD 加延期LC 治疗（36 例，为PTGD 组）及同期直接LC 治疗（40 例，为Non-PTGD 组），观察并比较两组患者LC 手术时间、术中失血量、中转开腹率、术后并发症发生率及住院时间。结果 PTGD 组手术时间、住院时间均明显短于Non-PTGD 组（t =1.96、1.84，均P＜0.05）；PTGD 组术中失血量明显少于Non-PTGD 组（t =2.03，P＜0.05）；PTGD 组中转开腹率、术后并发症发生率均明显低于Non-PTGD 组（字2 =6.74、6.97，P＜0.05）。结论 PTGD 与LC 序贯微创治疗高危AC 疗效确切、安全，值得临床推广。 |
| 关键词: 腹腔镜 胆囊切除 经皮经肝胆囊穿刺引流术 急性胆囊炎 |
| DOI： |
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| 基金项目:温州市科技局项目 |
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| Percutaneous gallbladder puncture drainage and laparoscopic cholecystectomy as sequential minimally invasive treatment for patients with high-risk acute cholecystitis |
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HU Yiren, PAN Jianghua, WANG Yi, XIA Jianke, TONG Xiaochun, GONG Gonghao
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Wenzhou People’s Hospital
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| Abstract: |
| Objective To evaluate the efficacy of percutaneous gallbladder puncture drainage (PTGD) and laparoscopic cholecystectomy (LC) as sequential minimally invasive treatment for patients with high-risk acute cholecystitis(AC). Methods Seventy six AC patients were divided into two groups: 36 cases were treated with LC after PTGD (PTGD group) and 40 cases directly received LC treatment (non-PTGD group) based on the general condition, heart and lung function and B ultrasound results. Results The duration of surgery, intraoperative blood loss, length of hospital stay in PTGD group were significantly less than those in non-PTGD group (t = 1.96, 2.03, 1.84, all P＜0.05). Laparotomy rate and postoperative complications rate in PTGD group were significantly lower than those in non-PTGD group (字2 = 6.74 and 6.97, both P＜0.05). Conclusion The efficacy and safety of PTGD and LC sequential minimally-invasive treatment for high-resk AC patients are satisfectory. |
| Key words: Laparoscopic Cholecystectomy Percutaneous gallbladder puncture and drainage Acute cholecystitis |
