介入超声联合胆道镜治疗高龄高危急性 结石性胆囊炎患者的临床应用

Clinical application of interventional ultrasound combined with choledochoscope in aged and high-risk patients with acute calculous cholecystitis

摘要:

目的 探讨超声引导下胆囊穿刺置管引流联合胆道镜治疗高龄高危急性结石性胆囊炎患者的可行性及临床应用价值。方法 回顾性分析2011年7月-2013年6月于该中心就诊并接受该技术治疗的41例患者临床资料。患者首先在B超引导下行胆囊穿刺置管引流，随后扩张窦道，最后行胆道镜取石。结果 41例患者中37例成功治愈出院（90.2%），2例（4.9%）改行腹腔镜胆囊切除术治疗，2例（4.9%）病情缓解拔管后出院。主要并发症是出血（4.9%）、肠瘘（2.4%）及胆瘘（2.4%）。随访患者1例结石复发，1例出现消化不良。结论 该方法治疗高龄高危急性结石性胆囊炎患者安全有效，具有临床可行性及应用价值。

Abstract:

【Objective】 To investigate the feasibility and clinical value of ultrasound-guided gallbladder catheter drainage combined with choledochoscope in aged and high-risk patients with acute calculous cholecystitis. 【Methods】 Clinical data of 41 patients admitted from July 2011 to June 2013 were retrospectively analyzed. Patients were performed the ultrasound-guided gallbladder catheter drainage, the expansion of the sinus tracts and the removing of gallbladder stones with choledochoscope. 【Results】 A total of 37 cases (90.2%) were cured successfully in all of 41 cases. Two cases (4.9%) were diverted into laparoscopic cholecystectomy and 2 cases (4.9%) were discharged in remission after extubation. The main complications were bleeding (4.9%), intestinal fistula (4.9%) and biliary fistula (2.4%). In all follow-up patients, one was stone recurrence, and another was indigestion. 【Conclusion】 This approach was safe, effective and has significant feasibility, great clinical value in aged and high-risk patients with acute calculous cholecystitis.