关键词: 急性化脓性胆囊炎, 经皮经肝胆囊穿刺, 腹腔镜胆囊切除术, 序贯, 疗效

Abstract:

Objective To investigate the efficacy of percutaneous transhepatic gallbladder drainage (PTGD) and laparoscopic cholecystectomy in the sequential treatment of acute suppurative cholecystitis. Method A total of 94 patients with acute suppurative cholecystitis admitted to Shishou Changheng Rehabilitation Hospital from February 2020 to February 2021 were selected and divided into experimental group (n=47) and reference group (n=47) by random number table method. The control group was treated with laparoscopic cholecystectomy. The experimental group received sequential treatment with PTGD and laparoscopic cholecystectomy. The time of operation, amount of surgical blood loss, postoperative temperature recovery time, drainage time, pain degree, length of hospital stay and the probability of conversion to laparotomy were counted between the two groups, and the incidence of postoperative infection, abdominal effusion, biliary bleeding, biliary leakage and other related complications were followed up and compared between the two groups. Result The amount of surgical bleeding in the experimental group was less than that in the reference group, and the operation time, postoperative temperature recovery time,

drainage time and hospitalization days were shorter than that in the reference group, and the pain degree score was lower than that in the reference group, with significant differences (P ＜ 0.05). The conversion rates of patients in the experimental group and the reference group were 4.26% (2/47) and 17.02% (8/47), respectively, with significant difference (χ2=4.029, P ＜0.05). The incidence of postoperative complications was 6.38% in the experimental group and 21.28% in the reference group, and the difference was significant (P ＜ 0.05). Conclusion Sequential treatment of acute suppurative cholecystitis with PTGD and laparoscopic cholecystectomy can reduce the probability of patients switching to open, promote postoperative recovery and reduce the risk of postoperative complications.

Key words: Acute suppurative cholecystitis, Percutaneous transhepatic cholecystectomy, Laparoscopic cholecystectomy, Sequential, Curative effect