Comin Jules M, Cade Richard J, Little Andrew F
Department of Medical Imaging, St Vincent's Hospital Melbourne, Victoria, Australia.
J Med Imaging Radiat Oncol. 2010 Oct;54(5):457-61. doi: 10.1111/j.1754-9485.2010.02207.x.
Percutaneous cholecystostomy is well established as a temporising treatment option in selected patients presenting with acute cholecystitis. However, some patients who undergo cholecystostomy will have persistent discharge, which precludes catheter removal, or may not be medically suitable for future cholecystectomy. In these circumstances, percutaneous cystic duct stenting isa novel treatment option. It may delay or avoid the need for cholecystectomy, and thereby provide definitive treatment in a subset of patients who have acute cholecystitis and a high anaesthetic risk or limited life expectancy. Current application has been limited largely to patients with pre-existing malignant common bile duct strictures, but there is potential for the application to be broadened to include other subsets of patients. In this paper, we describe the technique used for percutaneous cystic duct stenting in a patient and report on its effectiveness. We also explore the technical considerations and consider the application of the procedure on other groups of patients.
经皮胆囊造瘘术作为治疗急性胆囊炎特定患者的临时治疗选择已得到广泛认可。然而，一些接受胆囊造瘘术的患者会出现持续性引流，这使得导管无法拔除，或者可能在医学上不适合未来进行胆囊切除术。在这种情况下，经皮胆囊管支架置入术是一种新的治疗选择。它可能会延迟或避免胆囊切除术的需要，从而为一部分患有急性胆囊炎且麻醉风险高或预期寿命有限的患者提供确定性治疗。目前该方法主要应用于已有恶性胆总管狭窄的患者，但有扩大应用范围以纳入其他患者亚组的潜力。在本文中，我们描述了在一名患者中进行经皮胆囊管支架置入术所使用的技术，并报告了其有效性。我们还探讨了技术要点，并考虑该手术在其他患者群体中的应用。
