内镜引流治疗急性胆囊炎的现状与进展

Current status and progress of endoscopic drainage for acute cholecystitis

急性胆囊炎的基础治疗方法为外科手术切除胆囊,尤其是腹腔镜胆囊切除术。但部分高危手术患者需要行胆囊引流术,传统引流方法为经皮经肝胆囊穿刺引流术。但近年来内镜下经十二指肠乳头胆囊引流术和内镜超声引导下胆囊引流术两种内镜引流方法飞速发展,且长期效果良好。笔者通过文献回顾,深入探讨2种内镜引流方法的历史发展、技术特点、技术比较、不良事件和长期效果等。

The fundamental treatment for acute cholecystitis is surgical cholecystectomy,especially laparoscopic cholecystectomy.Some high-risk surgical patients need gallbladder drainage.The traditional drainage method is percutaneous transhepatic gallbladder drainage.However,in recent years,two endoscopic approaches,including endoscopic transpapillary gallbladder drainage and endoscopic ultrasound-guided gallbladder drainage,have developed rapidly and have advantages in long-term outcomes.In this article,the authors discuss the historical development,technical characteristics,comparison between methods,adverse events and long-term outcomes of the two endoscopic drainage methods through literature review.