ＥＮＢＤ留置後に待期的に手術を施行した気腫性胆嚢胆管炎の１例

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  • A Case of Emphysematous Cholecystitis with Cholangitis Electively Operated on after Endoscopic Nasobiliary Drainage.

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A 63-year-old man admitted for surgery for emphysematous cholecystitis with pneumobilia mainly reported chills and shivering. Abdominal X-ray showed gas in the upper right abdomen near the gallbladder. Computed tomography showed gallstones and extensive gas in the gallbladder and intrahepatic bile duct. Under a diagnosis of emphysematous cholecystitis with cholangitis, we conducted endoscopic nasobiliary drainage (ENBD) and administered antibiotics immediately upon admission. After his general condition improved, we conducted elective cholecystectomy, choledocolithotomy, and T-tube drainage 4 days after ENBD. The postoperative course was uneventful and he was discharged on postoperative day 31. Emphysematous cholecystitis with cholangitis is generally treated by emergency surgery, which, however, involves risks. In this case, elective surgery could be done after ENBD, avoiding emergency surgery.

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