Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University Hospital of Verona, Verona, Italy.
Gastroenterology Department, Colentina Clinical Hospital, Carol Davila University of Medicine, Bucharest, Romania.
J Gastrointestin Liver Dis. 2019 Sep 1;28(3):339-347. doi: 10.15403/jgld-215.
Interventional endoscopic ultrasound (EUS) is a rapidly expanding field with a wide variety of indications, including different drainage procedures and delivery of locoregional treatment mainly for pancreatic solid tumors. Transgastric or transduodenal gallbladder drainage in high-risk patients with acute cholecystitis or biliary decompression in patients with unresectable distal biliary malignant obstruction who failed endoscopic retrograde colangiography is one of the newest areas of EUS-guided intervention. The large-caliber lumen apposing metal stents placed during these procedures allow direct endoscopic gallbladder access and the possibility of performing gallstone treatment or resection of mucosal polyps. The current review presents the indications of endoscopic gallbladder interventions and discusses the results of available studies, foreseeing future potential applications.
介入性内镜超声(EUS)是一个快速发展的领域,适应证广泛,包括各种引流术式和局部区域治疗的递送,主要用于胰腺实体肿瘤。对于急性胆囊炎的高危患者,经胃或经十二指肠胆囊引流术,以及对于内镜逆行胰胆管造影术失败的无法切除的远端胆道恶性梗阻患者,进行胆汁减压术,是 EUS 引导下介入治疗的最新领域之一。这些操作中放置的大口径吻合金属支架可直接进行内镜胆囊入路,并有可能进行胆囊结石治疗或切除黏膜息肉。本文综述了内镜下胆囊介入治疗的适应证,并讨论了现有研究结果,预测了未来的潜在应用。