Ultrasound-guided double-tract percutaneous cholecystostomy combined with choledochoscopic gallbladder-preserving cholecystolithotomy for elderly patients with acute calculous cholecystitis

Abstract

Objective To investigate the clinical efficacy of ultrasound-guided double-tract percutaneous cholecystostomy combined with choledochoscopic gallbladder-preserving cholecystolithotomy for the elderly patients with acute calculous cholecystitis. Methods The clinical data of 35 elderly patients with cholecystolithiasis who were admitted to the General Hospital of Chengdu Military Command from January 2012 to December 2013 were retrospectively analyzed. All the 35 patients received ultrasound-guided double-tract percutaneous drainage, and then received choledochoscopic gallbladder-preserving cholecystolithotomy. The long-term oral use of anti-inflammatory and cholagogue medications after operation reduced recurrence of cholecystolithiasis. All the patients were followed up by telephone interview and outpatient examination till June 30, 2014. Results All the 35 patients undergoing successfully the ultrasound-guided double-tract percutaneous cholecystostomy. Of the 35 patients, 1 patient with the puncture bleeding was cured successfully by symptomatic treatment, 1 patient was treated by cholecystectomy due to the unformed sinus tract under costal margin, and other 34 patients underwent successfully cholecystolithotomy. The follow-up was carried out for 4 to 24 months and 1 patient was diagnosed as with recurrence of cholecystolithiasic. Conclusion Ultrasound-guided double-tract percutaneous cholecystostomy combined with choledochoscopic gallbladder-preserving cholecystolithotomy for elderly patients with acute calculous cholecystitis is safe and feasible, with an advantage of promotional value. Key words: Cholecystolithiasis; Elderly patients; Gallbladder-preserving cholecystolithotomy; Cholecystostomy