目的    探讨超声引导下经皮经肝胆囊引流（percutaneous transhepatic gallbladder drainage，PTGD）在急性胰腺炎合并急性胆囊炎治疗中的应用。方法    回顾性分析南京军区南京总医院普通外科2009年1月至2012年5月行PTGD治疗的急性胰腺炎合并急性胆囊炎51例病人的临床资料。结果    51例病人均一次置管成功，无严重并发症发生，临床缓解率72.5%。引流后第1、7天白细胞、中性粒细胞比例较术前明显下降；引流后第3天高胆红素率、APACHEⅡ评分显著降低；1例病人因胰腺坏死感染发生感染性休克死亡，余病人均痊愈出院。胆囊穿刺管在AP病情稳定后1个月内行胆囊造影明确无胆道梗阻后拔除。结论    PTGD治疗急性胰腺炎合并急性胆囊炎简单、安全、有效，对改善病人预后有积极作用。

Percutaneous transhepatic gallbladder drainage to treat acute pancreatitis complicated with acute cholecystitis guided by ultrasound: a report of 51 cases        LI Gang，TONG Zhi-hui, ZOU Lei, et al. Medicine School of Nanjing University, Institute of General Surgery, Nanjing General Hospital of Nanjing Military Command, Nanjing210002, China
Corresponding author: LI Wei-qin, E-mail：liweiqindr@yahoo.com
Abstract    Objective    To evaluate the safety and efficacy of percutaneous transhepatic gallbladder drainage (PTGD) guided by ultrasound in the treatment of acute pancreatitis complicated with acute cholecystitis. Methods    The clinical data of 51 cases of acute pancreatitis complicated with acute cholecystitis performed PTGD from January 2009 to May 2012 in Nanjing General Hospital of Nanjing Military Command were analyzed retrospectively. Results    All the cases were performed PTGD successfully without serious complications in the first try. In 72.5% of cases, the symptoms and signs were relieved after PTGD. The white blood cell count and the percentage of neutrophils were decreased obviously on the 1st day and 7th day after drainage. The incidence of high bilirubin (≥34.2μmol/L) and APACHEⅡ scores were declined significantly on the 3rd day after drainage. One case died of sepsis shock, and others were cured. In all cases, the catheters were removed in 1 month while no biliary obstruction was certified in gallbladder radiography. Conclusion    PTGD is a simple, safe and effective treatment, which can make improvement of prognosis in acute pancreatitis complicated with acute cholecystitis.