| Theme |
Diagnostic and Interventional EUS -- Present Status and Future Perspectives |
| Title |
EUS-guided Gallbladder Drainage and Its Application of NOTES |
| Author |
Takao Itoi |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Atsushi Sohuni |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Fumihide Itokawa |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Toshio Kurihara |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Kentaro Ishii |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Shujiro Tsuji |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Takayoshi Tsuchiya |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Nobuhito Ikeuchi |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Junko Umeda |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Reina Tanaka |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Ryosuke Tonotsuka |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Miki Honjo |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Shuntaro Mukai |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Fuminori Moriyasu |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| [ Summary ] |
In general, early or emergency cholecystectomy is considered the gold standard for treatment for acute cholecystitis. Although cholecystectomy is relatively safe, the mortality rates for cholecystectomies in patients at high risk due to comorbid conditions is high. Therefore, high-risk patients have been treated with temporary therapy regimens to percutaneously decompress the gallbladder, e. g. percutaneous transhepatic gallbladder drainage (PTGBD) or aspiration (PTGBA). Apart from percutaneous transhepatic therapy, several endoscopists have reported that endoscopic transpapillary naso-gallbladder drainage or gallbladder stenting can also be used as palliative therapy for acute cholecystitis. In 2007, endoscopic ultrasosographyguided gallbladder drainage (EUS-GBD), which is divided into the categories of EUS-guided naso-gallbladder drainage and EUS-guided gallbladder drainage, was reported to be a viable alternative gallbladder drainage technique. Since that time, a number of studies of this technique have been conducted. Although the technical and clinical success of EUS-guided gallbladder drainage is almost 100 %, the complication rates range from 11 % to 33 %. Thus, until methodologies and dedicated devices are developed, we should be wary of potentially serious complications. |