首页> 外文期刊>The Egyptian Journal of Radiology and Nuclear Medicine >Surgical and non-surgical treatment of non-traumatic gallbladder perforation
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Surgical and non-surgical treatment of non-traumatic gallbladder perforation

机译:非创伤性胆囊穿孔的手术和非手术治疗

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Objective Our aim was to present a single-center experience in the management of gallbladder perforation (GBP). Patients and methods Adult patients who had GBP were managed surgically and percutaneously. Patients who were high risk surgical candidates or who refused surgery were managed by image guided percutaneous drainage. Results Thirty-seven patients (21 males, 16 females) with an average age of 64 ± 14 years had GBP. The number of patients with GBP type I, II, and III were 13, 21, and 3, respectively. All GBP types I and III patients were treated surgically. Eleven of GBP type II patients were treated surgically, and 10 were treated by percutaneous catheter drainage. The overall mortality rate was 27% (10/37). No procedure-related mortality rate among those patients who were treated percutaneously; however, 30 days post procedure, the mortality rate was 30%. All of these deaths were related to the patients’ comorbidities; none of them was due to septicemia but conversely in surgically treated patients, 5 died due to septicemia (3 in GBP type I and 2 in GBP type II) in the postoperative period and one patient died because of severe internal hemorrhage complicating acute pancreatitis and one patient died few months later because of myocardial infarction. Conclusion Surgery is the cornerstone of treatment for all types of GBP. Percutaneous catheter drainage is a safe and effective option for treating patients with localized disease with favorable outcome.
机译:目的我们的目的是介绍胆囊穿孔(GBP)管理的单中心经验。患者和方法对成年的GBP患者进行手术和经皮治疗。高危手术候选人或拒绝手术的患者通过影像引导经皮引流进行治疗。结果37例平均年龄为64±14岁的患者(GBP)为21例。 I型,II型和III型GBP患者分别为13、21和3。所有I型和III型GBP患者均接受了手术治疗。 II型GBP病人中有11例接受了手术治疗,而经皮导管引流治疗了10例。总死亡率为27%(10/37)。经皮治疗的患者中没有与手术相关的死亡率;但是,手术后30天,死亡率为30%。所有这些死亡都与患者的合并症有关。他们中没有一个是由于败血病引起的,但是相反,在接受外科手术治疗的患者中,有5人死于败血病(术后I型为3例,GBP II型为2例),一名因严重内出血并发急性胰腺炎而死亡。该患者几个月后因心肌梗塞死亡。结论手术是治疗所有类型GBP的基石。经皮导管引流术是治疗局部疾病患者并取得良好结果的一种安全有效的选择。

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