Effect of ultrasound-guided percutaneous transhepatic gallbladder drainage on the recovery of liver function, gastrointestinal function, and serum inflammatory indicators in patients with acute cholecystitis

doi:10.3877/cma.j.issn.2095-2015.2026.01.013

Abstract

Abstract:

Objective

To explore the effects of ultrasound-guided percutaneous transhepatic gallbladder drainage (UG-PTGBD) on liver function, gastrointestinal function recovery, and serum cortisol (Cor), α1-acid glycoprotein (AAG), and procalcitonin (PCT) in patients with acute cholecystitis (AC).

Methods

A retrospective study was conducted on 80 patients with AC from Xuzhou First People's Hospital from January 2022 to August 2024. They were divided into a control group and an observation group using a random number table method, with 40 patients in each group. The control group received laparoscopic cholecystectomy (LC), while the observation group received UG-PTGBD and LC treatment. Serum indicators, gastrointestinal function recovery, and incidence of complications of the two groups were compared, and logistic regression model was used to analyze the factors affecting surgical prognosis.

Results

The recovery time of postoperative exhaust, eating, and bowel sounds in the observation group were shorter than those in the control group (P<0.05). Three days after the operation, the levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, AAG, PCT, and Cor in the observation group were all lower than those in the control group (P<0.05). The logistic regression model analysis results showed that age, disease grading, treatment plan, and AAG level were risk factors for poor prognosis after AC surgery (P<0.05).

Conclusion

UG-PTGBD surgery can more effectively promote liver function recovery in patients with AC, accelerate gastrointestinal function recovery, reduce serum Cor, AAG, PCT levels, and accelerate postoperative recovery process.

Key words: Ultrasound-guided percutaneous transhepatic gallbladder drainage, Acute cholecystitis, Laparoscopic cholecystectomy, α1-acid glycoprotein, Gastrointestinal function, Prognosis

Bao Liu, Xiaochen Su, Guangfei Li, Mingjing Xu. Effect of ultrasound-guided percutaneous transhepatic gallbladder drainage on the recovery of liver function, gastrointestinal function, and serum inflammatory indicators in patients with acute cholecystitis[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2026, 16(01): 73-78.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2026.01.013

https://zhxhbyyxzz.cma-cmc.com.cn/EN/Y2026/V16/I01/73

Figures/Tables 7

References 21

[1]	Gallaher JR, Charles A. Acute cholecystitis: a review[J]. JAMA, 2022, 327(10): 965-975.
[2]	Mencarini L, Vestito A, Zagari RM, et al. The diagnosis and treatment of acute cholecystitis: a comprehensive narrative review for a practical approach[J]. J Clin Med, 2024, 13(9): 2695-2698.
[3]	Scala A, Trunfio TA, Improta G. Classification and regression model to manage the hospitalization for laparoscopic cholecystectomy[J]. Sci Rep, 2023, 13(1): 14700.
[4]	Alius C, Serban D, Bratu D G, et al. When critical view of safety fails: A practical perspective on difficult laparoscopic cholecystectomy [J]. Medicina, 2023, 59(8): 1491-1493.
[5]	汪昱, 徐建明, 莫玲斐. 急性结石性胆囊炎行腹腔镜胆囊切除术后并发症的危险因素分析及风险预测模型的建立[J]. 安徽医药, 2022, 26(10): 2068-2071.
[6]	Boregowda U, Chen M, Saligram S. Endoscopic ultrasound-guided gallbladder drainage versus percutaneous gallbladder drainage for acute cholecystitis: a systematic review and meta-analysis[J]. Diagnostics, 2023, 13(4): 657-660.
[7]	Dietrich CF, Arcidiacono PG, Bhutani MS, et al. Controversies in endoscopic ultrasound-guided biliary drainage[J]. Cancers, 2024, 16(9): 1616-1620.
[8]	詹峰, 张楷, 程宝亮, 等. 经皮经肝胆囊穿刺置管引流术后序贯腹腔镜胆囊切除术(LC)与一期LC治疗Ⅱ级急性胆囊炎疗效的倾向性评分匹配比较[J]. 中国普通外科杂志, 2023, 32(2): 171-180.
[9]	中华医学会外科学分会胆道外科学组. 急性胆道系统感染的诊断和治疗指南(2021版)[J]. 中华外科杂志, 2021, 59(6): 422-429.
[10]	Kwa CXW, Cui J, Lim DYZ, et al. Discordant American Society of Anesthesiologists Physical Status Classification between anesthesiologists and surgeons and its correlation with adverse patient outcomes[J]. Sci Rep, 2022, 12(1): 7110.
[11]	Sagami R, Mizukami K, Sato T, et al. Strategy Comparison of Endoscopic Ultrasound-Guided Gallbladder Drainage to Percutaneous Transhepatic Gallbladder Drainage, Following Failed Emergent Endoscopic Transpapillary Gallbladder Drainage[J]. J Clin Med, 2023, 12(22): 7034-7036.
[12]	Pesce A, Fabbri N, Feo CV. Vascular injury during laparoscopic cholecystectomy: An often-overlooked complication[J]. World J Gastroint Surg, 2023, 15(3): 338.
[13]	Bock K, Heidrich B, Zender S, et al. Percutaneous transhepatic ultrasound-guided gallbladder aspiration: Still a safe option for gallbladder decompression in patients at high surgical risk[J]. Med Ultrason, 2023, 25(1): 14-21.
[14]	黄昱, 王卓, 任承纲, 等. PTGD后不同时间行LC治疗急性结石性胆囊炎患者疗效研究[J]. 实用肝脏病杂志, 2023, 26(4): 568-571.
[15]	叶成, 辛颖, 张宪亮, 等. 经皮经肝穿刺胆囊置管引流术的研究进展[J]. 介入放射学杂志, 2022, 31(7): 733-737.
[16]	许颖, 罗琳雪, 黄莎莎, 等. 广泛性子宫切除术后胃肠道功能恢复策略的研究进展[J]. 广西医学, 2023, 45(22): 2764-2767, 2788.
[17]	Liu D, Liu H, Wu J, et al. Effects of Thoracic Paravertebral Blockon Inflammatory Response, Stress Response, Hemodynamics and Anesthesia Resuscitation inGallbladder Carcinoma[J]. Cell Mol Biol, 2022, 68(2): 171-177.
[18]	Kelliher LJS, Scott M. Modifying the Stress Response–Perioperative Considerations and Controversies[J]. Anesthesiol Clin, 2022, 40(1): 23-33.
[19]	Watanabe H, Bi J, Murata R, et al. A synthetic retinoic acid receptor agonist Am80 ameliorates renal fibrosis via inducing the production of alpha-1-acid glycoprotein[J]. Sci Rep, 2020, 10(1): 11424.
[20]	Li F, Shou Y, Zhu R, et al. Predictive value of peripheral blood α1‐acid glycoprotein in medical abortion outcomes with mifepristone and relativity of concentration[J]. Int J Gynecol Obstet, 2022, 158(1): 201-204.
[21]	沙爽. 血清上皮细胞膜结合黏液素1, α1-酸性糖蛋白水平与急性胆囊炎胆道炎症及预后的关系[J]. 安徽医药, 2024, 28(5): 962-965.

临床资料		观察组(n=40)	对照组(n=40)	t/χ²	P
性别[例(%)]	男	20(50.00)	21(52.50)	0.050	0.823
性别[例(%)]	女	20(50.00)	19(47.50)	0.050	0.823
年龄(岁,±s)		55.23±12.56	56.65±11.78	0.521	0.604
体重指数(kg/mg²,±s)		23.11±1.05	23.08±1.10	0.170	0.918
病程(d,±s)		4.35±0.54	4.34±0.58	0.887	0.445
受教育程度(年,±s)		10.68±1.10	10.73±1.06	0.687	0.494
吸烟[例(%)]	有	15(37.50)	13(32.5)	0.220	0.639
吸烟[例(%)]	无	25(62.50)	27(67.5)	0.220	0.639
饮酒[例(%)]	有	13(32.5)	15(37.50)	0.220	0.639
饮酒[例(%)]	无	27(67.5)	25(62.50)	0.220	0.639
合并疾病[例(%)]	高血压	11(27.5)	10(25.00)	0.065	0.799
合并疾病[例(%)]	糖尿病	10(25.00)	9(22.5)	0.069	0.793
ASA分级[例(%)]	Ⅰ级	25(62.50)	27(67.5)	0.230	0.669
ASA分级[例(%)]	Ⅱ级	15(37.50)	13(32.5)	0.230	0.669
病情分级[例(%)]	Ⅱ级	27(67.5)	25(62.50)	0.220	0.639
病情分级[例(%)]	Ⅲ级	13(32.5)	15(37.50)	0.220	0.639
手术时间(min,±s)		67.14±8.77	64.32±8.54	1.457	0.149
术中出血量(mL,±s)		66.55±8.69	65.55±8.99	0.508	0.614

临床资料		观察组(n=40)	对照组(n=40)	t/χ²	P
性别[例(%)]	男	20(50.00)	21(52.50)	0.050	0.823
性别[例(%)]	女	20(50.00)	19(47.50)	0.050	0.823
年龄(岁,±s)		55.23±12.56	56.65±11.78	0.521	0.604
体重指数(kg/mg²,±s)		23.11±1.05	23.08±1.10	0.170	0.918
病程(d,±s)		4.35±0.54	4.34±0.58	0.887	0.445
受教育程度(年,±s)		10.68±1.10	10.73±1.06	0.687	0.494
吸烟[例(%)]	有	15(37.50)	13(32.5)	0.220	0.639
吸烟[例(%)]	无	25(62.50)	27(67.5)	0.220	0.639
饮酒[例(%)]	有	13(32.5)	15(37.50)	0.220	0.639
饮酒[例(%)]	无	27(67.5)	25(62.50)	0.220	0.639
合并疾病[例(%)]	高血压	11(27.5)	10(25.00)	0.065	0.799
合并疾病[例(%)]	糖尿病	10(25.00)	9(22.5)	0.069	0.793
ASA分级[例(%)]	Ⅰ级	25(62.50)	27(67.5)	0.230	0.669
ASA分级[例(%)]	Ⅱ级	15(37.50)	13(32.5)	0.230	0.669
病情分级[例(%)]	Ⅱ级	27(67.5)	25(62.50)	0.220	0.639
病情分级[例(%)]	Ⅲ级	13(32.5)	15(37.50)	0.220	0.639
手术时间(min,±s)		67.14±8.77	64.32±8.54	1.457	0.149
术中出血量(mL,±s)		66.55±8.69	65.55±8.99	0.508	0.614

组别	例数	术后排气时间	术后进食时间	术后肠鸣音恢复时间
观察组	40	20.35±3.66	25.66±4.68	15.43±3.20
对照组	40	22.47±3.78	28.89±4.88	17.78±3.77
t		2.548	3.021	3.006
P		0.013	0.003	0.004

组别	例数	术后排气时间	术后进食时间	术后肠鸣音恢复时间
观察组	40	20.35±3.66	25.66±4.68	15.43±3.20
对照组	40	22.47±3.78	28.89±4.88	17.78±3.77
t		2.548	3.021	3.006
P		0.013	0.003	0.004

组别	例数	胆漏	肺部感染	出血	切口感染	总发生率
观察组	40	1(2.50)	2(5.00)	1(2.50)	1(2.50)	5(12.50)
对照组	40	3(7.50)	4(10.00)	3(7.50)	3(7.50)	13(32.50)

Please choose a citation manager

Content to export