Maekawa Satoshi, Nomura Ryosuke, Murase Takayuki, Ann Yasuyoshi, Oeholm Masayuki, Harada Masaru
Department of Gastroenterology and Hepatology, Japan Labour Health and Welfare Organization Niigata Rosai Hospital.
J UOEH. 2014 Dec 1;36(4):265-72. doi: 10.7888/juoeh.36.265.
Acute cholecystitis is an inflammatory disease of the gallbladder. Inflammation often remains in the gallbladder, but some patients may take a fatal course with exacerbation of inflammation. Although laparoscopic cholecystectomy is recommended for moderate and severe acute cystitis, sometimes cholecystectomy is impossible in elder patients. Because many elder patients have bad general conditions, cholecystectomy should not be performed. Such patients are generally treated by percutaneous transhepatic gallbladder drainage (PTGBD), but PTGBD has the risk of intra-abdominal bleeding. In previous reports, endoscopic gallbladder stenting (EGBS) has been shown to be an effective strategy in cirrhosis patients with symptomatic cholelithiasis as a bridge to transplantation. Recent studies on EGBS have demonstrated an effective long-term management of acute cholecystitis in elderly patients who are poor surgical candidates. Here, we reviewed EGBS for the management of acute cholecystitis.
急性胆囊炎是一种胆囊的炎症性疾病。炎症通常局限于胆囊，但有些患者可能会因炎症加重而出现致命病程。虽然对于中度和重度急性胆囊炎推荐行腹腔镜胆囊切除术，但老年患者有时无法进行胆囊切除术。由于许多老年患者全身状况较差，不应进行胆囊切除术。这类患者一般采用经皮经肝胆囊引流术（PTGBD）治疗，但PTGBD有腹腔内出血的风险。在以往的报道中，内镜下胆囊支架置入术（EGBS）已被证明是肝硬化合并有症状胆结石患者作为移植桥梁的一种有效策略。近期关于EGBS的研究表明，对于手术条件较差的老年患者，EGBS是急性胆囊炎长期有效治疗的方法。在此，我们综述了EGBS在急性胆囊炎治疗中的应用。
