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影像引导经皮胆囊穿刺引流术:挑战常规。

Image-guided percutaneous cholecystostomy: challenging the norms.

机构信息

Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Interventional Radiology Department, Bioclinic General Hospital of Athens, Marinou Geroulanou 15, 115 24, Athens, Greece.

出版信息

Abdom Radiol (NY). 2024 Mar;49(3):939-941. doi: 10.1007/s00261-023-04173-9. Epub 2024 Jan 31.

Abstract

Image-guided percutaneous cholecystostomy (IGPC) is a widely recognized and regularly employed procedure in numerous institutions, serving as an indispensable cornerstone in the management of patients with acute cholecystitis. The most up-to-date literature has found that the transperitoneal route is at least as safe as the transhepatic route and that both the trocar and Seldinger techniques are equally safe and effective. The above novel insights may offer reassurance and alleviate concerns among operators performing IGPC by dispelling the fixation on previously established beliefs and thus providing flexibility, which lightens the load on the operator. Future studies could further investigate these findings and shed light on potential disparities in the safety and efficacy profiles associated with the subcostal and intercostal approaches, different drainage catheter sizes, and/or the impact of operator experience on complication rates.

摘要

经皮胆囊穿刺引流术(IGPC)在许多机构中被广泛认可和常规应用,是治疗急性胆囊炎患者的不可或缺的基石。最新的文献发现,经腹膜途径至少与经肝途径一样安全,并且套管针和 Seldinger 技术同样安全有效。这些新的观点可能会为操作者提供安心,并减轻他们对先前既定观念的担忧,从而提供操作灵活性,减轻操作者的负担。未来的研究可以进一步探讨这些发现,并阐明与肋缘下和肋间入路、不同引流导管大小以及/或操作者经验对并发症发生率的影响相关的安全性和疗效特征方面的潜在差异。

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