Volume 42 Issue 12
Dec.  2021
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Xue-song LI, Yun XIA, Zhen WANG, Hao ZOU, Lin-hai HE, Lin WANG. Application of PTGD Combined with Elective LC in the Treatment of Cholecystolithiasis with Acute Onset of Chronic Cholecystitis[J]. Journal of Kunming Medical University, 2021, 42(12): 95-100. doi: 10.12259/j.issn.2095-610X.S20211226
Citation: Xue-song LI, Yun XIA, Zhen WANG, Hao ZOU, Lin-hai HE, Lin WANG. Application of PTGD Combined with Elective LC in the Treatment of Cholecystolithiasis with Acute Onset of Chronic Cholecystitis[J]. Journal of Kunming Medical University, 2021, 42(12): 95-100. doi: 10.12259/j.issn.2095-610X.S20211226

Application of PTGD Combined with Elective LC in the Treatment of Cholecystolithiasis with Acute Onset of Chronic Cholecystitis

doi: 10.12259/j.issn.2095-610X.S20211226
  • Received Date: 2021-09-24
    Available Online: 2021-11-17
  • Publish Date: 2021-12-15
  •   Objective   To investigate the efficacy of ultrasound-guided percutaneous transhepatic cholecystectomy combined with elective laparoscopic cholecystectomy in the treatment of cholecystolithiasis complicated with acute onset of chronic cholecystitis.   Methods  61 patients with cholecystolithiasis complicated with acute onset of chronic cholecystitis admitted to The 2nd Heptatopancreatobiliary Surgery Department of The Second Affiliated Hospital of Kunming Medical University and The General Surgery Department of Xishuangbanna Dai Autonomous Prefecture People’ s Hospital from January 2018 to September 2021 were retrospectively analyzed. All patients received PTGD in the acute stage, and 40 of them received elective LC after readmission. The clinical manifestations, laboratory examinations and imaging differences between patients before PTGD and before LC were compared, and PTGD and LC related complications and postoperative conditions were analyzed.   Results   40 patients returned to the hospital again for elective LC. Compared with before PTGD, the clinical manifestations of the patients, such as abdominal pain and fever, were improved or disappeared. WBC count decreased, alanine aminotransferase and aspartate aminotransferase decreased, and the difference was statistically significant (P < 0.05). Abdominal ultrasound showed that the gallbladder wall thickness was thinner and the longest diameter of the gallbladder was shortened, with statistical significance (P < 0.05). All the 40 patients who received LC were operated under laparoscope without conversion to laparotomy, biliary tract injury or complications, and all were cured and discharged from hospital.   Conclusion   PTGD combined with elective LC is effective in the treatment of cholecystolithiasis with acute attack of chronic cholecystitis, which can avoid biliary tract injury and reduce the conversion of LC to laparotomy.
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