老年重症急性胆管炎预先经皮肝穿刺胆道引流的意义

目的：探讨经皮肝穿刺胆道引流(PTCD)对老年重症急性胆管炎(ACST)的诊断及治疗价值。方法：21例不同原因老年ACST，采用经B超或X线透视引导下行PTCD，并结合进一步的手术或其它方法治疗，其中各种胆道结石手术治疗14例，胆道蛔虫取出1例，经内镜下十二指肠乳头切开胆总管取石2例，胆管金属支架置放3例，胰十二指肠切除1例。结果：10例有明显休克的老年ACST病人，经PTCD后2。12h内血压恢复正常；1-2周内血清胆红素降至正常12例。全部病人均痊愈出院，无死亡病例。结论：PTCD对老年ACST的诊断与治疗有重要意义，可明显提高手术治疗效果及降低死亡率。

The importance of percutaneous transhepatic cholangical drainage in the old patients with acute cholangitis of severe type

Aim: To discuss the value of percutaneous transhepatic cholangical drainage (PTCD) in old patients with acute cholangitis of severe type (ACST). Methods: PTCD guided by Type-B ultrasound or x-ray were induced in 21 cases of ACST. Among all these cases , 14 patients received biliary tract calculus operation; one patient had biliary tract ascarids taken; two patients were incision the papilla of duodenum and common bile duct had stone through endoscope taken; three patients had metal racks placed in their biliary tract; one patient received Whipple operation. Results: All of the 21 patients fully recovered after PTCD and other therapy. Conclusion:PTCD plays an important role in diagnosing and treating the old ACST patient and it can improve the operative effects and decrease the mortality rate.