title: TG13 indications and techniques for gallbladder drainage in acute cholecystitis (with videos).
abstract: Percutaneous transhepatic gallbladder drainage (PTGBD) is considered a safe alternative to early cholecystectomy, especially in surgically high-risk patients with acute cholecystitis. Although randomized prospective controlled trials are lacking, data from most retrospective studies demonstrate that PTGBD is the most common gallbladder drainage method. There are several alternatives to PTGBD. Percutaneous transhepatic gallbladder aspiration is a simple alternative drainage method with fewer complications; however, its clinical usefulness has been shown only by case-series studies. Endoscopic naso-gallbladder drainage and gallbladder stenting via a transpapillary endoscopic approach are also alternative methods in acute cholecystitis, but both of them have technical difficulties resulting in lower success rates than that of PTGBD. Recently, endoscopic ultrasonography-guided transmural gallbladder drainage has been reported as a special technique for gallbladder drainage. However, it is not yet an established technique. Therefore, it should be performed in high-volume institutes by skilled endoscopists. Further prospective evaluations of the feasibility, safety, and efficacy of these various approaches are needed. This article describes indications and techniques of drainage for acute cholecystitis.Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/guideline/tg13.html.
authors.affiliation: Department of Medicine and Clinical Oncology, Graduate School of Medicine Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan. tsuyuguchi@faculty.chiba-u.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuyuguchi
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.forename: Steven M
authors.initials: SM
authors.lastname: Strasberg
authors.forename: Henry A
authors.initials: HA
authors.lastname: Pitt
authors.forename: Myung-Hwan
authors.initials: MH
authors.lastname: Kim
authors.forename: Avinash N
authors.initials: AN
authors.lastname: Supe
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Miura
authors.forename: Harumi
authors.initials: H
authors.lastname: Gomi
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Kimura
authors.forename: Ryota
authors.initials: R
authors.lastname: Higuchi
authors.forename: Kohji
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Gabata
authors.forename: Jiro
authors.initials: J
authors.lastname: Hata
authors.forename: Shinya
authors.initials: S
authors.lastname: Kusachi
mesh_terms: D041881:Cholecystitis, Acute / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005704:Gallbladder; D006801:Humans