Effect of Sequentially Mini-Invasive Method for Elderly Acute Calculous Cholecystitis Patients Combined with Organ Dysfunction Syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIJun , CHENZhong-hao , WANGZhi-qiang

Department of General Surgery, Tong Ren Hospital, Jiao Tong University School of Medicine, Shanghai 200336, China;

Corresponding?author：

LIJun, Email: upinarm@163.com

Keywords：

Acute calculous cholecystitis; Organ dysfunction syndrome; Percutaneous transhepatic gallbladder drainage; Laparoscopic cholecystectomy; Effect

DOI：

10.7507/1007-9424.20150280

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the curative effect and the appropriate time of sequentially with minimal invasive methods in treatment of elderly acute calculous cholecystitis patients combined with organ dysfunction syndrome (ODS). Methods Clinical data of 67 elderly acute calculous cholecystitis patients combined with ODS who received treatment in our hospital from December 2010 to December 2013 were collected retrospectively. All of the 67 patients were treated with percutaneous transhepatic gallbladder drainage (PTGBD) under the guidance of B ultrasound or CT at first, as well as systemic anti infective therapy, and then underwent laparoscopic cholecystectomy (LC) sequentially when situation of body got well. Results All of the 67 patients (100%) were treated with PTGBD successfully, but only 65 patients finished the latter related test. For the 65 patients, compared with before PTGBD, the patient's pain, abdominal distention, vomiting, leukocyte count, neutrophil ratio, glutamic-pyruvic transaminase, total bilirubin, C-reactive protein, and temperature had gotten obviously better on 1 and 4 d after PTGBD (P<0.05). There were 3 patients dropped LC, 2 patients transferred to mini-incision cholecystectomy, and the rest of 60 patients underwent LC successfully. All of the patients recovery and discharged from hospital in 2-7 days after operation. Conclusion Sequentially mini-invasive method is a simple, easy, safe, effective, mini trauma, and quick recovery method for the elderly acute cholecystitis patients combined with the ODS.

Citation： LIJun, CHENZhong-hao, WANGZhi-qiang. Effect of Sequentially Mini-Invasive Method for Elderly Acute Calculous Cholecystitis Patients Combined with Organ Dysfunction Syndrome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(9): 1073-1077. doi: 10.7507/1007-9424.20150280 Copy

1.	?許軍, 翟博, 關英輝, 等. 急性膽囊炎腹腔鏡手術時機選擇. 中國實用外科雜志, 2011, 31(6):511-513.
2.	王庚壯, 李霆, 石利國. 老年急性膽囊炎手術時機和方式的選擇. 中國老年學雜志, 2013, 33(6):1272-1274.
3.	吳在德,吳肇漢. 外科學. 第7版,北京:人民衛生出版社,2008:46-64.
4.	Na BG, Yoo YS, Mun SP, et al. The safety and efficacy of percutan-eous transhepatic gallbladder drainage in elderly patients with acute cholecystitis before laparoscopic cholecystectomy. Ann Surgical Treat Res, 2015, 89(2):68-73.
5.	呂海龍, 姜玉峰, 彭心宇, 等. 經皮經肝膽囊穿刺置管引流術后并發癥的防治. 中國普通外科雜志, 2012, 21(2):235-237.
6.	Morse BC, Smith JB, Lawdahl RB, et al. Management of acute cholec-ystitis in critically ill patients:contemporary role for cholecystostomy and subsequent cholecystectomy. Am Surg, 2010, 76(7):708-712.
7.	Yokoe M, Takada T, Strasberg SM, et al. New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo Guidelines. J Hepatobiliary Pancreat Sci, 2012, 19(5):578-585.
8.	李軍, 張輝, 朱雷鳴, 等. 急性結石性膽囊炎行LC術難易程度的相關因素分析. 中國普通外科雜志, 2009, 18(8):782-785.
9.	Choi SB, Han HJ, Kim CY, et al. Early laparoscopic cholecystectomy is the appropriate management for acute gangrenous cholecystitis. Am Surg, 2011, 77(4):401-406.
10.	Lee SI, Na BG, Yoo YS, et al. Clinical outcome for laparoscopic cholecystectomy in extremely elderly patients. Ann Surg Treat Res, 2015, 88(3):145-151.
11.	Kuy S, Sosa JA, Roman SA, et al. Age matters:a study of clinical and economic outcomes following cholecystectomy in elderly Americans. Am J Surg, 2011, 201(6):789-796.
12.	Kim IG, Kim JS, Jeon JY, et al. Percutaneous transhepatic gallbladder drainage changes emergency laparoscopic cholecystectomy to an elective operation in patients with acute cholecystitis. J Laparoendosc Adv Surg Tech A, 2011, 21(10):941-946.
13.	Komatsu S, Tsukamoto T, Iwasaki T, et al. Role of percutaneous transhepatic gallbladder aspiration in the early management of acute cholecystitis. J Dig Dis, 2014, 15(12):669-675.
14.	李正起, 陳靈麗. PTGD治療急性膽囊炎的臨床療效觀察. 海南醫學院學報, 2012, 18(1):71-73.
15.	張輝, 陳琪, 王濤, 等. 膽囊穿刺造瘺后雙通道膽道鏡保膽取石與腹腔鏡膽囊切除術治療老年患者結石性膽囊炎療效的比較. 中國微創外科雜志, 2014, 20(12):1092-1096.
16.	Kuhn JP, Busemann A, Lerch MM, et al. Percutaneous biliary drainage in patients with nondilated intrahepatic bile ducts compared with patients with dilated intrahepatic bile ducts. ATR AM J Roentgenol, 2010, 195(4):851-857.
17.	Chang YR, Ahn YJ, Jang JY, et al. Percutaneous cholecystostomy for acute cholecystitis in patients with high comorbidity and reeva-luation of treatment efficacy. Surgery, 2014, 155(4):615-622.
18.	朱斌, 張展志, 張能維, 等. 急性膽囊炎"延期"腹腔鏡膽囊切除的手術技巧及并發癥預防. 中華肝膽外科雜志, 2011, 17(10):820-822.
19.	袁德漢, 陳應軍, 衛洪波, 等. 腹腔鏡膽囊切除術所致膽道損傷的相關危險因素分析. 中國內鏡雜志, 2013, 19(5):492-495.
20.	谷化劍, 馮賢松, 辛小燕. 醫源性膽道損傷的原因分析與防治策略. 中國普通外科雜志, 2013, 22(2):192-196..
21.	楊波, 周文平, 呂東文, 等. 經皮經肝膽囊穿刺引流術聯合LC治療伴發MODS的急性膽囊炎. 肝膽胰外科雜志, 2011, 23(5):411-412.
22.	Han IW, Jang JY, Kang MJ, et al. Early versus delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage. J Hepatobiliary Pancreat Sci, 2012, 19(2):187-193.
23.	胡志鵬. PTGD聯合LC治療高原地區老年急性膽囊炎. 中國普通外科雜志, 2014, 23(8):1152-1153.
24.	于浩, 劉武, 姜洪磊, 等. 超聲引導下經皮經肝膽囊穿刺引流聯合腹腔鏡膽囊切除術治療急性膽囊炎117例臨床報道. 中國普外基礎與臨床雜志, 2014, 21(8):951-953.
25.	邵青龍, 李全福, 劉建輝, 等. PTGBD治療高齡高危急性膽囊炎的應用. 肝膽外科雜志, 2011, 19(3):208-211.
26.	Khasawneh MA, Shamp A, Heller S, et al. Successful laparoscopic cholecystectomy after percutaneous cholecystostomy tube place-ment. J Trauma Acute Care Surg, 2015, 78(1):100-104.

1. ?許軍, 翟博, 關英輝, 等. 急性膽囊炎腹腔鏡手術時機選擇. 中國實用外科雜志, 2011, 31(6):511-513.
2. 王庚壯, 李霆, 石利國. 老年急性膽囊炎手術時機和方式的選擇. 中國老年學雜志, 2013, 33(6):1272-1274.
3. 吳在德,吳肇漢. 外科學. 第7版,北京:人民衛生出版社,2008:46-64.
4. Na BG, Yoo YS, Mun SP, et al. The safety and efficacy of percutan-eous transhepatic gallbladder drainage in elderly patients with acute cholecystitis before laparoscopic cholecystectomy. Ann Surgical Treat Res, 2015, 89(2):68-73.
5. 呂海龍, 姜玉峰, 彭心宇, 等. 經皮經肝膽囊穿刺置管引流術后并發癥的防治. 中國普通外科雜志, 2012, 21(2):235-237.
6. Morse BC, Smith JB, Lawdahl RB, et al. Management of acute cholec-ystitis in critically ill patients:contemporary role for cholecystostomy and subsequent cholecystectomy. Am Surg, 2010, 76(7):708-712.
7. Yokoe M, Takada T, Strasberg SM, et al. New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo Guidelines. J Hepatobiliary Pancreat Sci, 2012, 19(5):578-585.
8. 李軍, 張輝, 朱雷鳴, 等. 急性結石性膽囊炎行LC術難易程度的相關因素分析. 中國普通外科雜志, 2009, 18(8):782-785.
9. Choi SB, Han HJ, Kim CY, et al. Early laparoscopic cholecystectomy is the appropriate management for acute gangrenous cholecystitis. Am Surg, 2011, 77(4):401-406.
10. Lee SI, Na BG, Yoo YS, et al. Clinical outcome for laparoscopic cholecystectomy in extremely elderly patients. Ann Surg Treat Res, 2015, 88(3):145-151.
11. Kuy S, Sosa JA, Roman SA, et al. Age matters:a study of clinical and economic outcomes following cholecystectomy in elderly Americans. Am J Surg, 2011, 201(6):789-796.
12. Kim IG, Kim JS, Jeon JY, et al. Percutaneous transhepatic gallbladder drainage changes emergency laparoscopic cholecystectomy to an elective operation in patients with acute cholecystitis. J Laparoendosc Adv Surg Tech A, 2011, 21(10):941-946.
13. Komatsu S, Tsukamoto T, Iwasaki T, et al. Role of percutaneous transhepatic gallbladder aspiration in the early management of acute cholecystitis. J Dig Dis, 2014, 15(12):669-675.
14. 李正起, 陳靈麗. PTGD治療急性膽囊炎的臨床療效觀察. 海南醫學院學報, 2012, 18(1):71-73.
15. 張輝, 陳琪, 王濤, 等. 膽囊穿刺造瘺后雙通道膽道鏡保膽取石與腹腔鏡膽囊切除術治療老年患者結石性膽囊炎療效的比較. 中國微創外科雜志, 2014, 20(12):1092-1096.
16. Kuhn JP, Busemann A, Lerch MM, et al. Percutaneous biliary drainage in patients with nondilated intrahepatic bile ducts compared with patients with dilated intrahepatic bile ducts. ATR AM J Roentgenol, 2010, 195(4):851-857.
17. Chang YR, Ahn YJ, Jang JY, et al. Percutaneous cholecystostomy for acute cholecystitis in patients with high comorbidity and reeva-luation of treatment efficacy. Surgery, 2014, 155(4):615-622.
18. 朱斌, 張展志, 張能維, 等. 急性膽囊炎"延期"腹腔鏡膽囊切除的手術技巧及并發癥預防. 中華肝膽外科雜志, 2011, 17(10):820-822.
19. 袁德漢, 陳應軍, 衛洪波, 等. 腹腔鏡膽囊切除術所致膽道損傷的相關危險因素分析. 中國內鏡雜志, 2013, 19(5):492-495.
20. 谷化劍, 馮賢松, 辛小燕. 醫源性膽道損傷的原因分析與防治策略. 中國普通外科雜志, 2013, 22(2):192-196..
21. 楊波, 周文平, 呂東文, 等. 經皮經肝膽囊穿刺引流術聯合LC治療伴發MODS的急性膽囊炎. 肝膽胰外科雜志, 2011, 23(5):411-412.
22. Han IW, Jang JY, Kang MJ, et al. Early versus delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage. J Hepatobiliary Pancreat Sci, 2012, 19(2):187-193.
23. 胡志鵬. PTGD聯合LC治療高原地區老年急性膽囊炎. 中國普通外科雜志, 2014, 23(8):1152-1153.
24. 于浩, 劉武, 姜洪磊, 等. 超聲引導下經皮經肝膽囊穿刺引流聯合腹腔鏡膽囊切除術治療急性膽囊炎117例臨床報道. 中國普外基礎與臨床雜志, 2014, 21(8):951-953.
25. 邵青龍, 李全福, 劉建輝, 等. PTGBD治療高齡高危急性膽囊炎的應用. 肝膽外科雜志, 2011, 19(3):208-211.
26. Khasawneh MA, Shamp A, Heller S, et al. Successful laparoscopic cholecystectomy after percutaneous cholecystostomy tube place-ment. J Trauma Acute Care Surg, 2015, 78(1):100-104.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Sequentially Mini-Invasive Method for Elderly Acute Calculous Cholecystitis Patients Combined with Organ Dysfunction Syndrome

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content