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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 2
Feb.  2017
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Article Contents

Clinical effect of ultrasound- guided percutaneous transhepatic gallbladder drainage in treatment of acute cholecystitis

DOI: 10.3969/j.issn.1001-5256.2017.02.016
  • Received Date: 2016-10-25
  • Published Date: 2017-02-20
  • Objective To investigate the clinical effect of ultrasound- guided percutaneous transhepatic gallbladder drainage( PTGBD) in the treatment of acute cholecystitis.Methods A retrospective analysis was performed for the clinical data of 81 patients with acute cholecystitis who underwent ultrasound- guided PTGBD in General Hospital of Lanzhou Petrochemical Company from March 2013 to February 2016.The changes in related parameters after the placement of drainage tube were analyzed.The t- test was used for comparison of continuous data between groups.Results All the 81 patients underwent a successful one- time puncture.After the surgery,1 patient experienced tube dislodgement and 2 experienced obstructed bile drainage,while no patient experienced serious complications such as bleeding,bile leakage,and hemopneumothorax.Within 12 hours after surgery,there was a significant improvement in pain in the right upper quadrant and significant reductions in the major axis and radial width of the gallbladder( t = 13.28 and 9.54,P = 0.023 and 0.041),as well as significant reductions in white blood cell count and neutrophil count( t = 8.70 and 8.03,P = 0.028 and 0.034).Of all patients,38 achieved symptom remission after the placement of drainage tube and refused selective surgical treatment,and 43 underwent cholecystectomy within 3 months after surgery.Conclusion PTGBD is simple,convenient,visible,and safe and can effectively reduce patients' pain,increase the success rate of the treatment of acute cholecystitis,improve patients' clinical outcomes,and reduce the incidence of complications.It also provides the conditions of selective surgery for critically ill patients with acute cholecystitis,and therefore,it holds promise for clinical application.

     

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  • [1] Biliary Surgery Group,Surgery Branch of Chinese Medical Association.Diagnosis and treatment guidelines for acute biliary infection(2011 edition)[J].Chin J Dig Surg,2011,10(1):9-13.(in Chinese)中华医学会外科学分会胆道外科学组.急性胆道系统感染的诊断和治疗指南(2011版)[J].中华消化外科杂志,2011,10(1):9-13.
    [2]ZHU YR,WU Y,LUO BQ,et al.The treatment application of percutaneous transhepatic gallbladder drainage(PTGD)in acute obstructive cholecystitis with elderly and highrisk patients[J].JHepatobiliary Surg,2015,23(2):121-123.(in Chinese)朱耀荣,武杨,罗本清,等.经皮经肝胆囊穿刺引流术治疗高龄急性梗阻性胆囊炎治疗体会[J].肝胆外科杂志,2015,23(2):121-123.
    [3]ZHOU YC,GUO WX,YAN S,et al.Ultrasonic[M].6th ed.Beijing:People's Military Medical Press,2011:908.(in Chinese)周永昌,郭万学,燕山,等.超声医学[M].第六版.北京:人民军医出版社,2011:908.
    [4]ZHANG ZS,LIANG XY,HE XH.Ultrasound guided PTGBD in critically ill patients with acute cholecystitis[J/CD].Chin J Clinicians:Electronic Edition,2013,7(6):2493-2496.(in Chinese)张振松,梁晓宇,何向辉.经皮经肝胆囊穿刺引流术治疗危重急性胆囊炎患者的临床疗效分析[J/CD].中华临床医师杂志:电子版,2013,7(6):2493-2496.
    [5]DUBREUIL A,BONNEVILLE B,WINCKEL P.Percutaneous transhepatic drainage of the biliary tree[J].Nouv Presse Med,1979,8(11):862-864.
    [6]YU H,LIU W,JIANG HL,et al.Ultrasound-guided percutaneous transhepatic gallbladder drainage combined laparoscopic cholecystectomy in treatment of severe acute cholecystitis(report of 117cases)[J].Chin J Bases Clin Gen Surg,2014,21(8):951-953.(in Chinese)于浩,刘武,姜洪磊,等.超声引导下经皮经肝胆囊穿刺引流联合腹腔镜胆囊切除术治疗急性胆囊炎117例临床报道[J].中国普外基础与临床杂志,2014,21(8):951-953.
    [7]WANG H,CHEN Q,WANG T,et al.Ultrasound-guided double-tract percutaneous cholecystostomy combined with choledochoscopic gallbladder-preserving cholecystolithotomy for elderly patients with acute calculous cholecystitis[J].Chin J Dig Surg,2015,14(2):149-151.(in Chinese)王华,陈琪,汪涛,等.超声引导下双通道置管联合胆道镜保胆取石术治疗高龄急性结石性胆囊炎[J].中华消化外科杂志,2015,14(2):149-151.
    [8]JIANG YD,YU LP,QI XJ,et al.Percutaneous transhepatic gallbladder catheterizing drainage to treat acute critical cholecystitis guiding by ultrasound[J].Clin Med J China,2007,14(3):344-345.(in Chinese)姜宇东,于丽萍,戚晓军,等.超声引导下经皮经肝胆囊穿刺置管引流治疗急性重症胆囊炎[J].中国临床医学,2007,14(3):344-345.
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