岭南现代临床外科2025，Vol.25Issue(1)：19-23,5.DOI:10.3969/j.issn.1009-976X.2025.01.004
经皮经肝胆囊穿刺置管引流术联合LC治疗≥65岁老年中度急性胆囊炎的效果研究
Effect of percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystecto-my in patients≥65 years old with moderate acute cholecystitis
摘要
Abstract
Objective To investigate the effect of percutaneous transhepatic gallbladder drainage(PTGBD)combined with laparoscopic cholecystectomy(LC)versus direct LC in patients≥65 years old with moderate acute cholecystitis.Methods The clinical data of 97 patients≥65 years old with moder-ate acute cholecystitis admitted to our hospital from November 2020 to November 2023 were analyzed retrospectively.They were divided into PTGBD+LC group(41 cases)and LC group(56 cases)according to the different surgical procedures.The preoperative general condition,intraoperative bleeding,opera-tion time,intra-operative transit open rate,time of first exhaustion,postoperative pain level,postopera-tive abdominal drain time,postoperative hospitalization time,total hospitalization cost,total hospitaliza-tion time and surgical complications were compared between the two groups.Results The proportion of ASA grade>Ⅱ in PTGBD+LC group was higher than that in LC group(P<0.05).Intraoperative bleeding in PTGBD+LC group was less than that in LC group.The operation time,time of the first exhaustionand time of the postoperative hospital stay were shorter than that in LC group.The postoperative VAS score of 24 h was lower than that in LC group,but the total hospitalization cost and total hospital stay were greater than those in LC group(P<0.05).There was no statistically significant difference in the intra-operative transit open rate between two groups,with 0 cases in PTGBD+LC group and 4 casesin LC group.There was a statistically significant difference in the comparison of the rate of complications between the two groups(P<0.05),with 5 cases(12.2%)of complications in PTGBD+LC group and 17 cases(30.4%)in LC group.Conclusion PTGBD combined with LC can significantly reduce the difficulty and risk of surgery,improve the safety of LC,and accelerate postoperative recovery,making it a worthwhile option to consider for patients≥65 years old with moderate acute cholecystitis.关键词
经皮经肝胆囊穿刺置管引流术/腹腔镜胆囊切除术/急性胆囊炎Key words
percutaneous transhepatic gallbladder drainage/laparoscopic cholecystectomy/acute cholecystitis分类
临床医学引用本文复制引用
庄洪财,罗丹丹,何超..经皮经肝胆囊穿刺置管引流术联合LC治疗≥65岁老年中度急性胆囊炎的效果研究[J].岭南现代临床外科,2025,25(1):19-23,5.基金项目
汕头市医疗卫生科技计划项目(汕府科[2022]81号-6) （汕府科[2022]81号-6）
