Gulaya Karan, Desai Shamit S, Sato Kent
Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Division of Interventional Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Semin Intervent Radiol. 2016 Dec;33(4):291-296. doi: 10.1055/s-0036-1592326.
The role of percutaneous cholecystostomy (PC) in the management of acute cholecystitis and cholangitis is outlined in the revised 2013 Tokyo Guidelines. These two emergencies constitute the vast majority of PC performed today for therapeutic purposes, and research has repeatedly shown the utility of PC in these conditions. PC is typically employed in the management of critically ill patients who are not surgical candidates. Indications and contraindications to PC are reviewed. Additional innovative applications of PC have been developed since it was first described in 1980. These include biliary drainage, dilation of biliary strictures, and stenting of the biliary tree including the common bile duct. Special consideration must be given to the patient selection criteria when deciding who can benefit from PC. Patient comorbidities can also influence the PC technique employed. Both transhepatic and transperitoneal approaches have distinct advantages and disadvantages. The technical success rate for PC is 95 to 100% and the complication rate is extremely low. Most complications are minor.
经皮胆囊造瘘术（PC）在急性胆囊炎和胆管炎治疗中的作用在2013年修订的《东京指南》中有概述。这两种急症构成了如今绝大多数用于治疗目的的经皮胆囊造瘘术，并且研究反复表明经皮胆囊造瘘术在这些情况下的效用。经皮胆囊造瘘术通常用于不适宜手术的重症患者的治疗。本文对经皮胆囊造瘘术的适应证和禁忌证进行了综述。自1980年经皮胆囊造瘘术首次被描述以来，已经开发出了其他创新应用。这些应用包括胆道引流、胆管狭窄扩张以及胆道树（包括胆总管）的支架置入。在决定谁能从经皮胆囊造瘘术中获益时，必须特别考虑患者选择标准。患者的合并症也会影响所采用的经皮胆囊造瘘术技术。经肝和经腹途径都有各自的优缺点。经皮胆囊造瘘术的技术成功率为95%至100%，并发症发生率极低。大多数并发症都很轻微。
