经皮经肝胆囊穿刺术治疗老年急性胆囊炎的研究进展

作     者：李逸阳 戴力华 龚韩 宋新 张帆 杨超 

作者机构：吉首大学医学院湖南 吉首 吉首大学第一附属医院肝胆一科湖南 吉首 吉首大学第一附属医院乳甲外科湖南 吉首 

出 版 物：《临床医学进展》 (Advances in Clinical Medicine)

年 卷 期：2024年第14卷第9期

页      面：561-566页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：急性胆囊炎 老年患者 危重症 经皮经肝胆囊穿刺置管引流术 

摘      要：急性胆囊炎是常见的急腹症之一。近年来,随着微创技术的进步和外科医师腹腔镜水平的提升,腹腔镜下胆囊切除术已成为治疗急性胆囊炎的金标准,因其创伤小、操作简单、术后恢复快而备受推崇。但对于高龄、合并严重基础疾病的高危患者而言,急诊行LC存在着较高的手术风险。超声引导下经皮经肝胆囊穿刺引流术能够有效减轻胆囊压力、迅速缓解感染症状,目前已逐渐成为有手术禁忌的患者首选的治疗措施。本文对PTGBD的现状和问题进行综述,并对其未来前景进行讨论。Acute cholecystitis is one of the common acute abdominal diseases. In recent years, with the advancement of minimally invasive technology and the improvement of surgeons’ laparoscopic level, laparoscopic cholecystectomy has become the gold standard for the treatment of acute cholecystitis, which is highly respected because of its small trauma, simple operation, and fast postoperative recovery. However, for high-risk patients of advanced age and combined with severe underlying diseases, there is a high surgical risk of performing LC in emergency. Ultrasound-guided percutaneous transhepatic gallbladder puncture and drainage (PTGBD) can effectively reduce gallbladder pressure and rapidly alleviate the symptoms of infection, and has gradually become the preferred therapeutic measure for patients with contraindications to surgery. This article reviews the current status and problems of PTGBD and discusses its future prospects.