经皮经肝胆囊穿刺引流在肝胆微创外科的应用体会

Abstract

目的：探讨经皮经肝胆囊穿刺治疗高龄患者的经验和体会。方法：2012年1月至2014年12月选择68例急性结石性胆囊高龄、高危病人进行穿刺引流病例作回顾性分析。结果：68例均穿刺置管成功并且获得了有效的引流减压。患者的症状和体征在引流后1~2 d缓解或消失。术后1~5 d体温及白细胞计数逐步恢复正常，59例合并有胆囊结石的病人于2月后择期行胆囊切除术和/或胆道探查术。结论：对高龄急性结石性胆囊炎病人，经皮经肝胆囊穿刺引流是一种合适的手术方式，值得临床应用。 Objective: To summarize the experience of PTGBD in department of hepatobiliary surgery. Methods: The clinical data of 68 cases of acute cholecystitis performed from Jan. 2012 to Dec. 2014 in Shanghai Pudong hospital were analyzed retrospectively. Results: In 68 cases, both punctures were successful for effective drainage and decompression. The signs and symptoms of patients after drainage of 1 - 2 days eased or disappeared. After 1 - 5 days temperature and white blood cell count gradually returned to normal. In 59 patients with cystic and calculous, patients were undergoing elective gallbladder resection or bile duct exploration after 3 months. Conclusion: The gallbladder puncture drainage was a suitable operation method, it was worth clinical application.