关键词: 经皮经肝胆囊穿刺引流, 腹腔镜胆囊切除术, 急性胆囊炎

Abstract: Objective To evaluation of percutaneous transhepatic gallbladder drainage（PTGBD）guided by color doppler ultrasound for the treatment of high- risk groups for acute cholecystitis. Methods The clinical data of 41 high-risk patients with acute cholecystitis were analyzed retrospectively from March 2014 to April 2017. Results All patients were successfully completed the PTGBD. There were two cases of biliary hemorrhage，and cured after conservative treatment. No gall leakage，perforation and other complications occurred. Three patients had catheter dislocation ，who did not agree to the operation without further treatment due to the improvement of the symptoms. Three patients were unable to tolerate surgery due to cardiopulmonary function，and six cases patients did not agree with the surgical and removed drainage tube. The above cases were followed up for six to 24 months without acute cholecystitis. Twenty-nine cases were successfully underwent by LC，and no case was underwent laparotomy. LC came two weeks to three months after PTGBD. The operation time was 74.9±67.3 min，the intraoperative hemorrhage was 7.2 ± 9.2 ml，and the postoperative hospitalization time was 2.6 ±2.1 days. One cases of abdominal bleeding was found and cured after conservative treatment. The thickness of gallbladder wall was positively correlated with LC time ，and the correlation coefficient was 0.455. Conclusion Our Results confirmed that PTGBD should be considered the first alternative to surgical intervention in surgically high-risk patients with acute cholecystitis.

Key words: laparoscopic cholecystectomy, percutaneous transhepatic gallbladder drainage, acute cholecystitis