Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy Sequential Minimally Invasive for Acute Cholecystitis in High-risk Patients
|Keywords||Percutaneous transhepatic gallbladder drainage Laparoscopiccholecystectomy High-risk acute cholecystitis|
Objective To summarize the experience of using percutaneous transhepatic gallbladder drainage (PTGBD) followed by laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis in high-risk patients.Methods We reviewed clinical data of78patients with high-risk acute cholecystitis in our hospital between2006and2010.Assessment the value of PTGBD technology. According to whether got the PTGBD treatment. they were divided into PTGBD group and non-PTGBD group.Results There were31patients carry out the PTGBD treatment in the total78patients, a successful tube insertion was achieved in all patients of PTGBD group, the symptom remission in29patients (94%) within72hours after gallbladder drainage. The dislodgement of drainage tube occurred in2cases, and haemorrhage occurred in1case. After PTGBD25patients underwent a delayed LC,3patients of them converse to open cholecystectomy. Compared with the non-PTGBD group, the PTGBD group showed shorter LC time, less blood loss, lower conversion rate,lower complication and less hospital time (p<0.05). Two patients discharged themselves in the non-PTGBD group.Conclusion Percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy sequential minimally invasive for acute cholecystits in high-risk patients is a kind of safe and effective treatment, this technique is of great value in clinical practice.