CAJ | 학술논문

目的探讨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患者的疗效.方法回顾性分析2012年1月至2013年12月成都军区总医院收治的35例高龄(≥80岁)胆囊结石患者的临床资料,先在B超引导下行经皮胆囊双通道穿刺置管引流,后期联合胆道镜保胆取石术.术后长期口服消炎利胆药物,降低结石复发.采用电话和门诊随访,随访时间截至2014年6月30日.结果 35例患者B超引导下胆囊穿刺置管均一次性成功,1例发生穿刺后出血,经对症治疗止血成功;因置管窦道形成不佳改行胆囊切除术1例;余34例均成功取石;随访4～24个月,结石复发1例.结论双通道胆囊穿刺置管联合胆道镜保胆取石治疗高龄急性结石性胆囊炎,该手术方式方法简单、疗效可靠,具有推广价值.
목적 탐토초성인도하쌍통도치관연합담도경보담취석술치료고령급성결석성담낭염환자적료효.방법 회고성분석2012년1월지2013년12월성도군구총의원수치적35례고령(≥80세)담낭결석환자적림상자료,선재B초인도하행경피담낭쌍통도천자치관인류,후기연합담도경보담취석술.술후장기구복소염리담약물,강저결석복발.채용전화화문진수방,수방시간절지2014년6월30일.결과 35례환자B초인도하담낭천자치관균일차성성공,1례발생천자후출혈,경대증치료지혈성공;인치관두도형성불가개행담낭절제술1례;여34례균성공취석;수방4～24개월,결석복발1례.결론 쌍통도담낭천자치관연합담도경보담취석치료고령급성결석성담낭염,해수술방식방법간단、료효가고,구유추엄개치.
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.