CAJ | 학술논문

目的：探讨急性非结石性胆囊炎的诊断及治疗方法。方法从1992年9月1日到2012年9月1日的1853位急性胆囊炎的病人中,有139位被术前诊断为急性非结石性胆囊炎。其中男性83例,女性56例,年龄9~89岁,平均67.4岁。结合国内外文献,对139名急性非结石性胆囊炎病人的临床资料进行总结及分析。98例病人接受了胆囊切除术或胆囊部分切除术,5例病人同时进行了胆总管探查术。41例病人因为存在手术禁忌原因选择经皮胆囊造瘘术。结果139例病人中98例病人接受了手术治疗,41例病人因为手术禁忌证的原因未能接受胆囊切除术,而选择经皮胆囊造瘘术。手术治疗组中有4例死亡,术中及术后发现共有3例存在结石样物质；胆囊造瘘组中有6例死亡,术后有8例发现胆汁引流物中存在结石样物质。结论急性非结石性胆囊炎的诊断通常在术前和术中作出,有一定的误诊率,部分病人可以在术后的胆囊造瘘管及胆道引流管内发现钙化样物质。
목적：탐토급성비결석성담낭염적진단급치료방법。방법종1992년9월1일도2012년9월1일적1853위급성담낭염적병인중,유139위피술전진단위급성비결석성담낭염。기중남성83례,녀성56례,년령9~89세,평균67.4세。결합국내외문헌,대139명급성비결석성담낭염병인적림상자료진행총결급분석。98례병인접수료담낭절제술혹담낭부분절제술,5례병인동시진행료담총관탐사술。41례병인인위존재수술금기원인선택경피담낭조루술。결과139례병인중98례병인접수료수술치료,41례병인인위수술금기증적원인미능접수담낭절제술,이선택경피담낭조루술。수술치료조중유4례사망,술중급술후발현공유3례존재결석양물질；담낭조루조중유6례사망,술후유8례발현담즙인류물중존재결석양물질。결론급성비결석성담낭염적진단통상재술전화술중작출,유일정적오진솔,부분병인가이재술후적담낭조루관급담도인류관내발현개화양물질。
Objective To explore the diagnosis and treatment of acute acalculous cholecystitis. Methods The clinical data of 139 acute acalculous cholecystitis inpatients were analyzed retrospective-ly.Results Among them,98 patients underwent surgery while another 41 percutaneons cholecystos-tomy because of surgical contraindications.Among 4 deaths,calculus was found in 3 patients in surgi-cal group;among 6 deaths,calculus in 8 patients in percutaneons cholecystostomy group.Conclusions Acute acalculous cholecystitis is often misdiagnosed since some calcareous substance may be drained from gallbladder and bile duct.