Maruta Akinori, Iwashita Takuji, Yoshida Kensaku, Shimizu Shogo, Shimizu Masahito
Department of Gastroenterology Gifu Prefectural General Medical Center Gifu Japan.
First Department of Internal Medicine Gifu University Hospital Gifu Japan.
DEN Open. 2025 May 6;6(1):e70133. doi: 10.1002/deo2.70133. eCollection 2026 Apr.
Acute cholecystitis is frequently encountered in daily clinical practice, and early cholecystectomy is the standard therapy. In high-risk surgical patients, such as those with advanced age, deteriorated performance status, or underlying diseases, conservative treatment is typically preferred to manage acute cholecystitis. However, in patients with a disease that is refractory to conservative treatment, drainage procedures are necessary to control the infection. At present, there are three basic approaches for gallbladder drainage: percutaneous transhepatic gallbladder drainage, endoscopic transpapillary gallbladder drainage, and endoscopic ultrasound gallbladder drainage. Each of these methods has advantages and disadvantages. Therefore, the appropriate treatment method is determined on a case-by-case basis, and no consistent strategy for gallbladder drainage has been established. This review aimed to summarize the characteristics of each drainage method and compare the clinical outcomes of the three procedures for acute cholecystitis in high-risk surgical patients.
急性胆囊炎在日常临床实践中经常遇到，早期胆囊切除术是标准治疗方法。在高危手术患者中，如高龄、身体状况恶化或有基础疾病的患者，通常首选保守治疗来处理急性胆囊炎。然而，对于保守治疗无效的患者，引流手术对于控制感染是必要的。目前，胆囊引流有三种基本方法：经皮经肝胆囊引流、内镜经乳头胆囊引流和内镜超声引导下胆囊引流。这些方法各有优缺点。因此，合适的治疗方法需根据具体情况确定，目前尚未建立统一的胆囊引流策略。本综述旨在总结每种引流方法的特点，并比较这三种手术治疗高危手术患者急性胆囊炎的临床结果。
