Erschienen in:
01.01.2013 | Guideline
TG13 indications and techniques for gallbladder drainage in acute cholecystitis (with videos)
verfasst von:
Toshio Tsuyuguchi, Takao Itoi, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Myung-Hwan Kim, Avinash N. Supe, Toshihiko Mayumi, Masahiro Yoshida, Fumihiko Miura, Harumi Gomi, Yasutoshi Kimura, Ryota Higuchi, Kohji Okamoto, Yuichi Yamashita, Toshifumi Gabata, Jiro Hata, Shinya Kusachi
Erschienen in:
Journal of Hepato-Biliary-Pancreatic Sciences
|
Ausgabe 1/2013
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Abstract
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.