Techniques of biliary drainage for acute cholecystitis: Tokyo Guidelines.
The principal management of acute cholecystitis is early cholecystectomy. However, percutaneous transhepatic gallbladder drainage (PTGBD) may be preferable for patients with moderate (grade II) or severe (grade III) acute cholecystitis. For patients with moderate (grade II) disease, PTGBD should be applied only when they do not respond to conservative treatment. For patients with severe (grade III) disease, PTGBD is recommended with intensive care. Percutaneous transhepatic gallbladder aspiration (PTGBA) is a simple alternative drainage method with fewer complications; however, its clinical usefulness has been shown only by case-series studies. To clarify the clinical value of these drainage methods, proper randomized trials should be done. This article describes techniques of drainage for acute cholecystitis.
Tsuyuguchi
Toshio
T
Department of Medicine and Clinical Oncology, Graduate School of Medicine Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, 260-8677, Japan.
Takada
Tadahiro
T
Kawarada
Yoshifumi
Y
Nimura
Yuji
Y
Wada
Keita
K
Nagino
Masato
M
Mayumi
Toshihiko
T
Yoshida
Masahiro
M
Miura
Fumihiko
F
Tanaka
Atsushi
A
Yamashita
Yuichi
Y
Hirota
Masahiko
M
Hirata
Koichi
K
Yasuda
Hideki
H
Kimura
Yasutoshi
Y
Neuhaus
Horst
H
Strasberg
Steven
S
Pitt
Henry
H
Belghiti
Jacques
J
Belli
Giulio
G
Windsor
John A
JA
Chen
Miin-Fu
MF
Kim
Sun-Whe
SW
Dervenis
Christos
C
D041881:Cholecystitis, Acute / Q000000981:diagnostic imaging / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D016145:Endoscopy, Digestive System; D005704:Gallbladder / Q000000981:diagnostic imaging; D006801:Humans; D014041:Tokyo; D014463:Ultrasonography