| Theme | Advances in Diagnosis and Endoscopic Treatment for Pancreatic and Biliary Lesion | |
|---|---|---|
| Title | Drainage for Cholecystitis and Cholangitis | |
| Publish Date | 2007/06 | |
| Author | Takahiro Urata | Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author | Hiroyuki Maguchi | Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author | Kuniyuki Takahashi | Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author | Akio Katanuma | Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author | Manabu Osanai | Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author | Shinpei Matsusaki | Center for Gastroenterology, Teine-Keijinkai Hospital |
| [ Summary ] | Early cholecystectomy is recommended for acute cholecystitis, according to treatment guidelines. However, emergency operations are possible only in limited institutions. Thus, being adept in drainage methods is important. While percutaneous transhepatic drainage methods PTGBD and PTGBA are generally prevalent, the endoscopic drainage method (ENGBD) is starting to draw attention. However, ENGBD is highly difficult, its success rate being around 80 %. Therefore, new devices for this technique, and developments and improvements in tools are anticipated. On the other hand, endoscopic drainage is a primary choice for acute cholangitis. It is indispensable to understand the merits and demerits of endoscopic biliary stenting (EBS) and ENBD, and to appropriately choose the correct method. Furthermore, it is advisable to master precutting methods in case of difficulties with bile duct cannulation. The percutaneous transhepatic drainage method should also be mastered in case of difficulties with the endoscopic approach. | |