Cholecystectomy versus percutaneous cholecystostomy drainage in critically ill patients with acute calculous syndrome: a comparative study

Hadidi, Amro El; Negm, Ahmed; Halim, M. A.; Basheer, Magdy; Samir, Mohamed; Attia, Mohamed

doi:10.4103/ejs.ejs_104_18

Cited by 3 publications

(4 citation statements)

References 4 publications

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“…There are few studies comparing the two different treatment approaches and, to date, only one randomized clinical trial [21]. The studies supporting PTGBD as a definitive treatment are almost all retrospective, dated or based on a limited number of cases [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]; therefore, it can be stated that the current medical literature does not provide solid evidence of the benefits of PTGBD. This systematic review and meta-analysis were conducted to analyze the advantages and disadvantages of PTGBD as a definitive treatment compared with EC in the management of the critically ill patient with AC.…”

Section: Discussionmentioning

confidence: 99%

“…After removing duplicates and analyzing the remaining titles, abstracts and additional articles, 31 studies remained for full-text analysis. Of these, 14 were excluded because of a lack of data; therefore, only 17 articles were included: 1 RCT [21]; 2 PCS [22,23]; 8 RCS [24][25][26][27][28][29][30][31] and 6 SAD [32][33][34][35][36][37].…”

Section: Literature Searchmentioning

confidence: 99%

“…However, the patients who underwent percutaneous drainage had an older age with respect to those who had EC. BMI was assessed by a few studies [21,24,25,29]; La Greca et al reported that the BMI was analyzed, but they did not provide further data in this regard [27]. Surgical risk was assessed in all studies, but different classifications of surgical risk were used.…”

Section: Literature Searchmentioning

confidence: 99%

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Management of Acute Cholecystitis in High-Risk Patients: Percutaneous Gallbladder Drainage as a Definitive Treatment vs. Emergency Cholecystectomy—Systematic Review and Meta-Analysis

Cirocchi

Amato²,

Ungania

et al. 2023

JCM

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Background: This systematic review aims to investigate whether percutaneous transhepatic gallbladder biliary drainage (PTGBD) is superior to emergency cholecystectomy (EC) as a definitive treatment in high-risk patients with acute cholecystitis (AC). Material and Methods: A systematic literature search was performed until December 2022 using the Scopus, Medline/PubMed and Web of Science databases. Results: Seventeen studies have been included with a total of 783,672 patients (32,634 treated with PTGBD vs. 4663 who underwent laparoscopic cholecystectomy, 343 who had open cholecystectomy and 746,032 who had some form of cholecystectomy, but without laparoscopic or open approach being specified). An analysis of the results shows that PTGBD, despite being less invasive, is not associated with lower morbidity with respect to EC (RR 0.77 95% CI [0.44 to 1.34]; I2 = 99%; p = 0.36). A lower postoperative mortality was reported in patients who underwent EC (2.37%) with respect to the PTGBD group (13.78%) (RR 4.21; 95% CI [2.69 to 6.58]; p < 0.00001); furthermore, the risk of hospital readmission for biliary complications (RR 2.19 95% CI [1.72 to 2.79]; I2 = 48%; p < 0.00001) and hospital stay (MD 4.29 95% CI [2.40 to 6.19]; p < 0.00001) were lower in the EC group. Conclusions: In our systematic review, the majority of studies have very low-quality evidence and more RCTs are needed; furthermore, PTGBD is inferior in the treatment of AC in high-risk patients. The definition of high-risk patients is important in interpreting the results, but the methods of assessment and definitions differ between studies. The results of our systematic review and meta-analysis failed to demonstrate any advantage of using PTGBD over ER as a definitive treatment of AC in critically ill patients, which suggests that EC should be considered as the treatment of choice even in very high-risk patients. Most likely, the inferiority of PTGBD versus early LC for high-risk patients is related to an association of various patient-side factor conditions and the severity of acute cholecystitis.

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Section: Discussionmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

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Management of Acute Cholecystitis in High-Risk Patients: Percutaneous Gallbladder Drainage as a Definitive Treatment vs. Emergency Cholecystectomy—Systematic Review and Meta-Analysis

Cirocchi

Amato²,

Ungania

et al. 2023

JCM

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“…Positive findings on intraoperative cholangiography lead to intraoperative management of CBDS with prolonged operative time. In this case we utilized ERCP plus sphincterotomy as a combination of intraoperative procedure with the rendezvous technique [1,11,25]. Its morbidity includes pancreatitis, cholangitis, hemorrhage, duodenal perforation or allergy to contrast.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Approach to Acute Cholecystitis in a Severely Cardiopathic Patient: Case Report and Review of Literature on Treatment Strategies

Pantalone¹,

Alemanno²,

Stefàno³

et al. 2020

SCR

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Acute cholecystitis in severely cardiopathic patients after major cardiac surgery represents a challenge for surgeons. Treatment with cholecystostomy, may offer a chance to these patients, however there is still a number of controversial issues on the topic: performance surgical techniques (transhepatic or transpapillary), optimal duration and timing of drain removal, the need for further tests before removal as well as the timing for definitive surgery. We therefore deemed it important to share our experience of a multidisciplinary approach for the definitive treatment of this patient with severe heart disease. A percutaneous cholecystostomy was the chosen strategy for a 58-year-old cardiopathic patient who had undergone surgery for hip replacement and had developed acute calculous cholecystitis a few days after surgery. Two weeks after discharge, a cholangiography through the cholecystostomy and an MRI cholangiopancreatography revealed the presence of stones in the cystic duct and in the ductus choledochus. The definitive treatment was decided after consulting with a multidisciplinary team. The choice was to perform an open cholecystectomy with simultaneous removal of the cholecystostomy, endoscopic removal of stones and sphincterotomy of the Oddi papilla. Currently, the patient is healthy and his heart function satisfactory. Although early cholecystectomy is the recommended choice for acute cholecystitis, a patient with severe co-morbidities may benefit from a bridging therapy before definitive surgery and a multidisciplinary approach can provide a safer solution.

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Karydakis procedure versus Limberg flap for treatment of pilonidal sinus: an updated meta-analysis of randomized controlled trials

Emile

Khan

Barsom

et al. 2021

Int J Colorectal Dis

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Cholecystectomy versus percutaneous cholecystostomy drainage in critically ill patients with acute calculous syndrome: a comparative study

Cited by 3 publications

References 4 publications

Management of Acute Cholecystitis in High-Risk Patients: Percutaneous Gallbladder Drainage as a Definitive Treatment vs. Emergency Cholecystectomy—Systematic Review and Meta-Analysis

Management of Acute Cholecystitis in High-Risk Patients: Percutaneous Gallbladder Drainage as a Definitive Treatment vs. Emergency Cholecystectomy—Systematic Review and Meta-Analysis

Multidisciplinary Approach to Acute Cholecystitis in a Severely Cardiopathic Patient: Case Report and Review of Literature on Treatment Strategies

Karydakis procedure versus Limberg flap for treatment of pilonidal sinus: an updated meta-analysis of randomized controlled trials

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