TG13 indications and techniques for gallbladder drainage in acute cholecystitis (with videos)
TG13 indications and techniques for gallbladder drainage in acute cholecystitis (with videos)
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DOI：
10.1007/s00534-012-0570-2
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发表时间：
2013-01-01
影响因子：
3
通讯作者：
Kusachi, Shinya
中科院分区：
文献类型：
--
作者：
Tsuyuguchi, Toshio;Itoi, Takao;Kusachi, Shinya
经皮肝穿胆囊引流术(PTGBD)被认为是一种安全的替代早期胆囊切除术的方法，尤其是在外科高危急性胆囊炎患者中。尽管缺乏随机前瞻性对照试验，但大多数回顾性研究的数据表明，PTGBD是最常见的胆道引流方法。PTGBD有几种替代方案。经皮经肝穿吸术是一种简单的替代引流方法，并发症较少；然而，其临床应用只有通过病例系列研究才能显示出来。鼻胆管引流术和经纤维胆道镜胆囊管内支架置入术也是治疗急性胆囊炎的替代方法，但这两种方法都存在技术困难，成功率低于PTGBD。近年来，超声内窥镜引导下经壁胆道引流已被报道为一种特殊的胆道引流技术。然而，这还不是一项成熟的技术。因此，应在大容量机构中由熟练的内窥镜医生进行。需要对这些不同方法的可行性、安全性和有效性进行进一步的前瞻性评估。本文描述了急性胆囊炎的引流适应症和引流技术。免费全文文章和TG13的移动应用程序可通过http://www.jshbps.jp/en/guideline/tg13.html.获得
Percutaneous transhepatic gallbladder drainage (PTGBD) is considered a safe alternative to early cholecystectomy, especially in surgically high-risk patients with acute cholecystitis. Although randomized prospective controlled trials are lacking, data from most retrospective studies demonstrate that PTGBD is the most common gallbladder drainage method. There are several alternatives to PTGBD. Percutaneous transhepatic gallbladder aspiration is a simple alternative drainage method with fewer complications; however, its clinical usefulness has been shown only by case-series studies. Endoscopic naso-gallbladder drainage and gallbladder stenting via a transpapillary endoscopic approach are also alternative methods in acute cholecystitis, but both of them have technical difficulties resulting in lower success rates than that of PTGBD. Recently, endoscopic ultrasonography-guided transmural gallbladder drainage has been reported as a special technique for gallbladder drainage. However, it is not yet an established technique. Therefore, it should be performed in high-volume institutes by skilled endoscopists. Further prospective evaluations of the feasibility, safety, and efficacy of these various approaches are needed. This article describes indications and techniques of drainage for acute cholecystitis.Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/guideline/tg13.html.