Korean Journal of Gastrointestinal Endoscopy 2001;22(1): 27-31.
수술 고위험군 급성 담낭염 환자에서의 경피경간적 담낭경검사의 안전성과 유용성 ( Safety and Usefulness of Percutaneous Transhepatic Cholecystoscopy (PTCCS) in High-Risk Surgical Patients Manifesting Acute Cholecystitis )
유지숙(Chi Sook Yoo),김홍자(Hong Ja Kim),김하영(Ha Young Kim),이경아(Kyung A Lee),정성희(Sung Hee Chung),정세라(Sae Ra Jung),송희곤(Hee Gon Song),주연호(Yeon Ho Joo),서동완(Dong Wan Seo),이성구(Sung Koo Lee),김명환(Myung Hwan Kim),민영일(Young Il Min)
Abstract
Background/Aims: The aim of the present study is to identify the diagnostic and therapeutic usefulness of percutaneous transhepatic cholecystoscopic examination (PTCCS) in high-risk surgical patients manifesting acute cholecystitis. Methods: Between January 1992 and June 1998, 33 consecutive patients who underwent percutaneous transhepatic cholecystostomy (PC) and subsequent PTCCS for the management of acute cholecystitis were included. Results: PC and subsequent PTCCS were successfully accomplished in all of 33 patients. During PTCCS, minor complication (2 of minor bleeding during electrohydraulic lithotripsy, 2 of tube dislodgement and 1 of bile leakage to peritoneum) occurred in five patients. PTCCS revealed 26 cases of gallstones, 3 cases of sludge ball, 3 cases of gallbladder carcinoma and 1 case of clonorchiasis related with acute cholecystitis. Three cases of the gallbladder cancers which were not predicted radiologically were incidentally found during PTCCS. For 26 patients with gallstones, PTCCS and concomitant stone removal were successfully carried out in one to four consecutive sessions (mean 2.2 sessions). Gallstones recurred in three (3/22, 14%) patients during the mean follow-up period of 27 months. All of them remain asymptomatic. Conclusions: PTCCS may be justified in the management of acute cholecystitis in selected patients with high surgical risk. (Korean J Gastrointest Endosc 2001;22:27 - 31)
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