急性胆囊炎

胆囊壁增厚伴白细胞浸润、壁内脓肿和坏死。这可能导致胆囊穿孔和胆囊周围脓肿形成。[2]Kimura Y, Takada T, Strasberg SM, et al. TG13 current terminology, etiology, and epidemiology of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):8-23. http://link.springer.com/content/pdf/10.1007%2Fs00534-012-0564-0.pdf http://www.ncbi.nlm.nih.gov/pubmed/23307004?tool=bestpractice.com

一种罕见的胆囊切除术并发症。疗法包括内镜下支架植入术、经皮经肝扩张术和手术重建术。早期识别和适当的多学科专科医师会诊是实现最佳预后的基石。

由胆结石经过胆道进入肠道（通过瘘管进入）引起，导致小肠梗阻。[3]Indar AA, Beckingham IJ. Acute cholecystitis. BMJ. 2002 Sep 21;325(7365):639-43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1124163 http://www.ncbi.nlm.nih.gov/pubmed/12242178?tool=bestpractice.com 胆结石在经过通道时增大。治疗为进行肠切开术（临近梗阻部位，因为存在受损肠闭合的风险）取出结石。随后在无炎症的 4 至 6 周间隔时间内进行胆囊切除术。

瘘的最常见部位是十二指肠和结肠肝曲。

胆囊因瘘减压可能会缓解急性胆囊炎。[3]Indar AA, Beckingham IJ. Acute cholecystitis. BMJ. 2002 Sep 21;325(7365):639-43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1124163 http://www.ncbi.nlm.nih.gov/pubmed/12242178?tool=bestpractice.com [84]Mallick B, Bhattacharya A, Gupta P, et al. Cholecystocolic fistula diagnosis with hepatobiliary scintigraphy: a case report. JGH Open. 2019 Feb;3(1):91-3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386746 http://www.ncbi.nlm.nih.gov/pubmed/30834347?tool=bestpractice.com