Clinical Gastroenterology Vol.33 No.5(9)

Theme Indications and Standards of Practice for Emergency Endoscopy
Title Emergency Drainage Therapy in Acute Cholangitis and Acute Cholecystitis
Publish Date 2018/05
Author Keiichi Hatamaru Second Department of Internal Medicine, Wakayama Medical University
Author Yuki Kawaji Second Department of Internal Medicine, Wakayama Medical University
Author Junya Nuta Second Department of Internal Medicine, Wakayama Medical University
Author Takashi Tamura Second Department of Internal Medicine, Wakayama Medical University
Author Masahiro Itonaga Second Department of Internal Medicine, Wakayama Medical University
Author Masayuki Kitano Second Department of Internal Medicine, Wakayama Medical University
[ Summary ] Owing to its minimally invasive nature, endoscopic drainage is being widely accepted as emergency drainage therapy in acute cholangitis and cholecystitis. The timing of treatment and the drainage method to be utilized should be based on the "Guidelines for Acute Cholangitis and Cholecystitis 2013". However, the optimal treatment method should be based on the patient's background and the drainage method, which the endoscopist is good at. In a few postoperative cases and a few patients undergoing unsuccessful ERCP in whom endoscopic bile duct drainage is difficult, because of the development of endoscopic instruments, enteroscopy assisted drainage and EUS have now become possible, and EUS-guided drainage has been developed as a new therapy for acute cholecystitis. Standardization of such treatment in the future would lead to the development of further endoscopic therapy.
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