The application value of color ultrasound-guided percutaneous transhepatic gallbladder drainage for severe cholecystitis in elderly patients

LI Huan; LONG Hui; HE Fei

doi:10.3969/j.issn.1674-3806.2019.02.18

Abstract：Objective To explore the application value of color ultrasound-guided percutaneous transhepatic gallbladder drainage ( PTGBD) for severe cholecystitis in elderly patients. Methods The clinical data of 64 elderly patients with severe cholecystitis in our hospital from January 2015 to June 2018 were analyzed retrospectively. Of the64 elderly patients, 34 cases were treated with PTGBD under color Doppler ultrasound guidance on the basis of medical treatment ( PTGBD group), and 30 cases were given conservative treatment ( control group). The changes of body temperature, abdominal pain score and white blood cell count, erythrocyte sedimentation rate, hypersensitive C-reactive protein, procalcitonin, gamma-glutamyl transpeptidase, total bilirubin, direct bilirubin, hospitalization time and hospitalization costs were statistically analyzed and compared before and after PTGBD treatment between the two groups. Results Compared with those in the control group, the patients in PTGBD group had shorter hospitalization time and less hospitalization costs ( P ＜ 0. 05). The body temperature of the patients in PTGBD group dropped to normal within 72 hours after operation, and the abdominal pain improved significantly. Leukocyte count, erythrocyte sedimentation rate, hypersensitive C-reactive protein, procalcitonin, gamma-glutamyl transpeptidase, total bilirubin, direct bilirubin, and international standardized ratio in the patients in PTGBD group after treatment were reduced significantly within one week and the differences were statistically significant compared with those before treatment ( P ＜0. 05). Conclusion Color ultrasound-guided PTGBD has the advantages of minimal wounding. It can quickly reduce the pressure inside the gallbladder and prevent sepsis and has a high application value for elderly patients with severe cholecystitis who have surgery contraindication.