| 袁超,白剑峰.胆囊穿刺同期胆道镜取石治疗高龄结石性胆囊炎效果分析[J].安徽医药,2017,21(11):2032-2034. |
| 胆囊穿刺同期胆道镜取石治疗高龄结石性胆囊炎效果分析 |
| Analysis of the effect of gallbladder puncture and choledochoscopy in the treatment of elderly patients with calculous cholecystitis |
| 投稿时间：2017-01-07 |
| DOI： |
| 中文关键词: 高龄 急性结石性胆囊炎 胆囊穿刺 胆道镜 双频激光 |
| 英文关键词: Elderly patients Acute Calculous Cholecystitis Gallbladder puncture Choledochoscope Dual frequency laser |
| 基金项目: |
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| 中文摘要: |
| 目的 分析探讨CT引导经皮经肝胆囊穿刺造瘘同期胆道镜取石治疗高龄高危急性结石性胆囊炎的疗效。方法 选择40例年龄在70岁以上的患有急性结石性胆囊炎,胆囊明显增大(胆囊长径>10 cm,横径>4 cm,胆囊泥沙样结石,或结石单发直径在1 cm以下,或结石5枚以下,直径<0.5 cm)的患者,在CT引导下穿刺置管引流胆汁,在导丝的引导下置入经皮肾镜用扩展套管扩张窦道,置入胆道镜取石网篮取石,较大结石借助双频激光碎石后取石或冲洗吸出碎石,留置引流管,2个月后复查B超后拔管,治疗结束。结果 40例患者均穿刺置管成功,37例取石成功,取石成功患者至发文前无一例胆囊炎复发,无一例胆囊结石复发。结论 CT引导下经皮经肝胆囊穿刺同期胆道镜取石术是治疗部分高龄患者急性结石性胆囊炎有效的方法,值得继续研究,扩大适应证。 |
| 英文摘要: |
| Objective To evaluate the efficacy of CT guided percutaneous transhepatic gallbladder fistula and choledochoscopy in the treatment of elderly and high-risk acute calculous cholecystitis. Methods Forty patients aged over 70 with acute calculous cholecystitis and gall bladder increased obviously(gallbladder diameter >10 cm long,diameter >4 cm,gall bladder stones sediment samples,single or calculi under 1 cm in diameter,or calculi under five,diameter <0.5 cm) were selected in the First Affiliated Hospital of Nanjing Medical University from January 2015 to June 2016.With the guidance of CT,gallbladder bile was discharged by puncturing tube.By placing percutaneous nephroscope fistula with the guidance of thread sinus tract were expanded.By placing reticular basket with the guidance of choledochoscope the stone were taken.The larger calculi were taken by double frequency laser lithotripsy after flushing suction out of the rubble,indwelling drainage tube.After two months,we pull out the tube after ultrasound. Results 40 cases were successfully treated by puncture and catheterization,and 37 cases were successfully removed.There was no recurrence of cholecystitis before delivery. Conclusions With the guidance of CT,percutaneous gallbladder puncture combined with choledochoscope is an effective method for treating some elderly patients with high-risk acute calculous cholecystitis,which is worthy of further investigation and expand the indications. |
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