経皮経肝的胆嚢ドレナージ後に腹腔鏡下胆嚢摘出術を施行しえた気腫性胆嚢炎の１例

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  • A Case of Emphysematous Cholecystits Treated with Laparoscopic Cholecystectomy after Percutaneus Transhepatic Gallbladder Drainage.

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A 71-year-old man admitted for right hypochondriac pain. Abnormal gas in the gallbladder and intrahepatic bile duct was found in abdominal ultrasonography (us) and computed tomography (CT). Under a diagnosis of emphysematous cholecystitis, we immediately conducted percutaneous transhepatic gallbladder drainage (PTGBD). Cultured bile yielded positive Eubacterium species. Laparoscopic cholecystectomy was conducted on 22nd day after PTGBD. The patient recovered and was discharged on the postoperative day 10. Emphysematous cholecystitis is relatively rare, caused by gas-forming bacteria in the gallbladder. The first choice of treatment for emphysematous cholecystitis may be early surgery because the disease involve a risk of gangrene and perforation of the gallbladder wall. Recently, it has been increasingly reported that patients with poor risk undergo PTGBD, and were followed by cholecystectomy after recovery from the disease. We consider laparoscopic cholecystectomy after improvement of the general condition of the patient by PTGBD to be effective in treating emphysematous cholecystitis.

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