ULTRASOUND-GUIDED PERCUTANEOUS TRANSHEPATIC GALLBLADDER DRAINAGE FOLLOWED BY LAPAROSCOPIC CHOLECYSTECTOMY - A NEW TRIAL IN THE TREATMENT OFSEVERE ACUTE SUPPURATIVE CHOLECYSTITIS

Seven cases of acute suppurative cholecystitis underwent percutaneous transhepatic gallbladder drainage followed by laparoscopic cholecystec tomy at the Tainan Municipal Hospital. All the patients had frank sept ic phenomena clinically, including fever, jaundice, leukocytosis and u nstable blood pressure. Organisms were cultured from both blood and bi le specimens. Ultrasound-guided transhepatic puncture of the gallbladd er was performed for bile drainage, and laparoscopic cholecystectomy w as subsequently performed two to five days later after the patients ha d stabilized. No procedure-related complications from either percutane ous transhepatic gallbladder drainage or laparoscopic cholecystectomy were observed. All patients had early recovery, shortened hospital sta y and good cosmetic results. These preliminary results show that lapar oscopic cholecystectomy is a safe method and can be employed in those patients with symptomatic gallstone associated with suppurative cholec ystitis after preoperative biliary drainage.