Oku Takatomi, Horii Toru, Masaka Tomohiro, Miseki Tetsuya, Sakai Takashi, Kamiga Takahiro
Department of Gastroenterology, Obihiro Daiichi Hospital, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2013 Jun;110(6):989-97.
Early cholecystectomy has become the standard treatment for acute cholecystitis. However, gallbladder drainage is often performed before surgery. In the present study, we compared the clinical outcomes between patients who underwent endoscopic naso-gallbladder drainage (ENGBD) and those who underwent percutaneous transhepatic gallbladder drainage (PTGBD). PTGBD was superior to ENGBD in terms of success rate and procedure time. However, there was no significant difference in the rate of complications, improvement effect on inflammation, the length of hospitalization, the duration from drainage to operation, and operation time. Although PTGBD has become the first choice for cases requiring gallbladder drainage, ENGBD should be considered the most appropriate therapy in cases with a contraindication for PTGBD due to antithrombotic treatment, those associated with choledocholithiasis, and those suspected of gallbladder cancer. The importance of ENGBD is expected to increase in the future.
早期胆囊切除术已成为急性胆囊炎的标准治疗方法。然而,术前常进行胆囊引流。在本研究中,我们比较了接受内镜鼻胆管引流术(ENGBD)和经皮经肝胆管引流术(PTGBD)患者的临床结局。PTGBD在成功率和操作时间方面优于ENGBD。然而,在并发症发生率、炎症改善效果、住院时间、引流至手术的时间以及手术时间方面,两者无显著差异。虽然PTGBD已成为需要胆囊引流病例的首选,但对于因抗血栓治疗而有PTGBD禁忌证、合并胆总管结石以及怀疑胆囊癌的病例,ENGBD应被视为最合适的治疗方法。预计ENGBD的重要性在未来会增加。