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Techniques of biliary drainage for acute cholecystitis: Tokyo Guidelines |
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| Authors: | Toshio Tsuyuguchi Tadahiro Takada Yoshifumi Kawarada Yuji Nimura Keita Wada Masato Nagino Toshihiko Mayumi Masahiro Yoshida Fumihiko Miura Atsushi Tanaka Yuichi Yamashita Masahiko Hirota Koichi Hirata Hideki Yasuda Yasutoshi Kimura Horst Neuhaus Steven Strasberg Henry Pitt Jacques Belghiti Giulio Belli John A Windsor Miin-Fu Chen Sun-Whe Kim Christos Dervenis |
| Institution: | Department of Medicine and Clinical Oncology, Graduate School of Medicine Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, 260-8677, Japan Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan Mie University School of Medicine, Mie, Japan Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan Department of Emergency Medicine and Critical Care, Nagoya University School of Medicine, Nagoya, Japan Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan Department of Surgery, Fukuoka University Hospital, Fukuoka, Japan Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Science, Kumamoto, Japan First Department of Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan Department of Surgery, Teikyo University Ichihara Hospital, Chiba, Japan Department of Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany Department of Surgery, Washington University in St Louis and Barnes-Jewish Hospital, St Louis, USA Department of Surgery, Indiana University School of Medicine, Indianapolis, USA Department of Digestive Surgery and Transplantation, Hospital Beaujon, Clichy, France Department of General and HPB Surgery, Loreto Nuovo Hospital, Naples, Italy Department of Surgery, The University of Auckland, Auckland, New Zealand Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan Department of Surgery, Seoul National University College of Medicine, Seoul, Korea First Department of Surgery, Agia Olga Hospital, Athens, Greece |
| Abstract: | 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. |
| Keywords: | Acute cholecystitis Cholecystostomy Drainage Percutaneous Endoscopy Acalculous cholecystitis Guidelines |
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