关键词: 急性胆囊炎, 经皮经肝胆囊穿刺引流术, 腔镜下胆囊切除术, 治疗

Abstract: Objective To observe the clinical efficacy of percutaneous transhepatic gallbladder drainage （PTGBD） and delayed laparoscopic cholecystectomy（LC） combination in the treatment of patients with acute cholecystitis （AC）.Methods A retrospective study was conducted on 94 patients with AC admitted to our hospital between August 2015 and August 2017. 47 patients in observation received PTGBD and delayed LC treatment,and another 47 in the control received emergent LC.Results In the observation group,the operation time was （83.2±34.1） min,significantly shorter than [（119.0±36.4） min,P<0.05] in the control,blood loss was （33.7±15.5） ml,much less than 【（60.4±16.7） ml,P<0.05】 in the control,the postoperative anal exhaust was （23.5±6.6） h,significantly shorter than 【（27.2±5.1） h,P<0.05】 in the control,the postoperative abdominal drainage was （3.4±2.0） d,significantly shorter than 【（9.1±3.1） d,P<0.05】 in the control,while total hospital stay was（11.2±4.7） d,significantly longer than【（8.3±3.0） d,P<0.05】 in the control;the rates of conversion to open surgery and direct open surgery in observation group were 4.3% and 0.0%,significantly lower than 17.0% and 12.8% （P<0.05） in the control;72 hours after operation,the while blood cell counts,serum ALT,AST and bilirubin levels were significantly lower than those in the control （P<0.05）;the incidences of short-term complications in the observation was 8.5%,much lower than 29.8% （P<0.05） in the control. Conclusion The application of PTGBD and thereafter delayed LC in the treatment of patients with AC is definitely efficacious,which might effectively reduce the conversion rate to open surgery and the incidence of post-operational Complications.

Key words: Acute cholecystitis, Percutaneous transhepatic gallbladder drainage, Delayed laparoscopic cholecystectomy, Therapy