内镜下经十二指肠乳头胆囊引流术治疗急性胆囊炎的研究现状

Research status of endoscopic transpapillary gallbladder drainage for the treatment of acute cholecystitis

摘要:

腹腔镜胆囊切除术是治疗急性胆囊炎的首选治疗方法，但部分手术风险高的患者全身麻醉风险较大，早期手术并发症及死亡率高。因此，简单、快速、微创、有效的胆囊引流技术应运而生，包括经皮经肝胆囊引流术、内镜下经十二指肠乳头胆囊引流术、超声内镜引导下胆囊引流术，有效的胆囊减压也为后续的择期手术提供了可能。本文就内镜经十二指肠乳头胆囊引流术治疗急性胆囊炎的历史背景、技术挑战与创新、人群选择、疗效、不良事件以及治疗成本等进行了综述。

Abstract:

Laparoscopic cholecystectomy is the preferred treatment for acute cholecystitis. However, patients at high surgical risk face significant challenges with general anesthesia, and the associated risk of early postoperative complications and mortality remains high. Consequently, a range of minimally invasive, rapid, and effective gallbladder drainage techniques have emerged, including percutaneous transhepatic gallbladder drainage, Endoscopic transpapillary gallbladder drainage, and endoscopic ultrasound-guided gallbladder drainage. These procedures not only provide effective gallbladder decompression to alleviate acute symptoms but also create the possibility for subsequent elective surgery once the patient is stabilized. This article reviews the historical background, technical challenges and innovations, patient selection criteria, effectiveness, adverse events, and treatment costs associated with endoscopic transduodenal papilla gallbladder drainage for acute cholecystitis management.