Image-Guided Cholecystostomy Tube Placement: Short- and Long-Term Outcomes of Transhepatic Versus Transperitoneal Placement

Beland, Michael D.; Patel, Lakir; Ahn, Sun Ho; Grand, David

doi:10.2214/ajr.18.19669

Cited by 34 publications

(37 citation statements)

References 11 publications

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“…Our study found that the pain index during and 12 h after puncture in the PPGD group was higher than in the PHGD group. Beland et al[ 18 ] found that the pain index of the two groups was the same, and there was no significant difference. The reason may be that in Beland’s study, two different Seldinger or trocar techniques were applied in the two groups.…”

Section: Discussionmentioning

confidence: 99%

Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

Liu¹,

Wu²,

Zhu³

et al. 2020

WJG

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BACKGROUND B-mode-ultrasound-guided percutaneous cholecystostomy (PC) may be performed by a transhepatic or transperitoneal approach, called percutaneous transhepatic gallbladder drainage (PHGD) and percutaneous transperitoneal gallbladder drainage (PPGD), respectively. We compared the impact of PC related to the route of catheter placement on subsequent laparoscopic cholecystectomy (LC). AIM To compare the impact of PC related to the route of catheter placement on subsequent LC. METHODS We retrospectively studied 103 patients with acute calculous cholecystitis who underwent scheduled LC after PC between January 2010 and January 2019. Group I included 58 patients who underwent scheduled LC after PHGD. Group II included 45 patients who underwent scheduled LC after PPGD. Clinical outcomes were analyzed according to each group. RESULTS Baseline demographic characteristics did not differ significantly between both groups ( P > 0.05). Both PHGD and PPGD were able to quickly resolve cholecystitis sepsis. Group I showed significantly higher efficacy than group II in terms of lower pain score during puncture (3.1 vs 4.5; P = 0.001) and at 12 h follow-up (1.5 vs 2.2; P = 0.001), lower rate of fever within 24 h after PC (13.8% vs 42.2%; P = 0.001), shorted operation duration (118.3 vs 139.6 min; P = 0.001), lower amount of intraoperative bleeding (72.1 vs 109.4 mL; P = 0.001) and shorter length of hospital stay (14.3 d vs 18.0 d; P = 0.001). However, group II had significantly lower rate of local bleeding at the PC site (2.2% vs 20.7%; P = 0.005) and lower rate of severe adhesion (33.5% vs 55.2%; P = 0.048). No significant differences were noted between both groups regarding the conversion rate to laparotomy, rate of subtotal cholecystectomy, complications and pathology. CONCLUSION B-mode-ultrasound-guided PHGD is superior to PPGD followed by LC for treatment of acute calculous cholecystitis, with shorter operating time, minimal amount of intraoperative bleeding and short length of hospital stay.

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Section: Discussionmentioning

confidence: 99%

Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

Liu¹,

Wu²,

Zhu³

et al. 2020

WJG

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“…Despite this shape, clinical reports demonstrate that pigtail catheters continue to have high dislodgment and obstruction rates which require reintervention and increased costs. 19 In one study examining percutaneous cholecystostomy, unplanned readmissions related to the catheter were seen in 71% of patients at a mean follow-up of 834 days. 20 Of those readmitted, tube dislodgment accounted for 40% of readmissions, and tube obstruction accounted for 29% of readmissions.…”

Section: Discussionmentioning

confidence: 99%

Drainage Performance of a Novel Catheter Designed to Reduce Drainage Catheter Failure

Bishawi

Feiger

Kurupassery

et al. 2020

J Clin Interv Radiol ISVIR

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Objective Efficient flow of fluids through drainage/infusion catheters is affected by surrounding tissue, organ compression, and scar tissue development, limiting or completely obstructing flow through drainage holes. In this work, we introduce a novel three-dimensional (3D) drainage catheter with protected side holes to reduce flow blockages. We then compare its drainage performance to standard straight and pigtail catheters using computer-generated catheter designs and flow analysis software. Methods Drainage performance was computed as flow rate through the catheter for a given pressure differential. Each catheter contained drainage holes on the distal (insertion) end and a single outlet (hub) hole open to atmosphere. Computational fluid dynamics using ANSYS AIM 18.2 was used to simulate flow through the catheter and examine drainage performance based on variations to the following parameters: (1) side hole shape, (2) cross-sectional area of the catheters, (3) number of side holes, and (4) cross-sectional area of the side holes. Results Drainage through the newly introduced catheter in all simulations was nearly identical to standard pigtail and straight catheters. While working to optimize the 3D catheter design, we found that the changes in side hole shape and side hole cross-sectional area had little effect on the total flow rate through the catheters but had a large impact on flow rate through the side hole nearest to the hub (proximal hole). Additionally, the majority of flow in all catheters occurred at the most proximal 1 to 3 side holes closest to hub, with relatively little flow occurring at side holes more distally located (closest to insertion end). The 3D catheter demonstrated no changes in flow characteristics when the coiled segment was occluded, giving it an advantage over other catheter types when the catheter is compressed by surrounding tissue or other external obstruction. Conclusions The majority of fluid flow in catheters with a diameter of 4.67 mm (14 Fr) or smaller occurred at the most proximal 1 to 3 side holes. A novel 3D coiled catheter design can protect these proximal holes from external blockage while maintaining drainage performance compared with standard straight and pigtail catheters.

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“…Our experience corresponds to these published data. In the literature, articles are also available which revealed a non-significant difference in complication rates between the transhepatic and transperitoneal approaches [22, 23].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous cholecystostomy in the management of acute cholecystitis - 10 years of experience.

Dvorák¹,

Hoffmann²,

Renc³

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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A b s t r a c tIntroduction: The preferred treatment for acute cholecystitis is cholecystectomy, but for patients with precluded general anesthesia due to critical illness or multiple medical comorbidities it is not suitable. Cholecystostomy could be a minimally invasive therapeutic alternative. Aim: To retrospectively evaluate the indications, technical features, efficacy, complications, patients' development and relationships among monitored parameters of percutaneous computed tomography (CT)-guided cholecystostomies in cases of acute cholecystitis and find the role of this procedure in appropriate treatment selection. Material and methods: Over the course of 10 years, 75 percutaneous cholecystostomy procedures in 69 patients were performed in cases with diagnosed acute cholecystitis, precluded general anesthesia and contraindicated cholecystectomy by an experienced surgeon and anesthesiologist. These interventions were done using only local anesthesia. The patients were men in 39 cases and women in 33 cases, aged 33 to 91 years. Results: Technical success was achieved in all cases. The indications were sepsis in 34 (45.3%) cases, bridging acute gallbladder inflammatory status in 15 (20%) interventions, serious medical comorbidities in 8 (10.7%) cases, disseminated malignancy and cardiac failure in 6 cases each (both 8%) and neurological affections in 5 (6.5%) cases. Cholecystostomy was frequently the final solution in acalculous cholecystitis (79.3%). The 30-day mortality rate was determined at 10.7% and the overall complication rate was 21.3%, but all of these complications were managed conservatively or using minimally invasive treatment. Conclusions: Percutaneous CT-guided cholecystostomy is reserved for patients with a serious medical status for various reasons that preclude surgical treatment and general anesthesia. Simultaneously, technical success and efficacy are high and the complication rate is acceptable.

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Image-Guided Cholecystostomy Tube Placement: Short- and Long-Term Outcomes of Transhepatic Versus Transperitoneal Placement

Cited by 34 publications

References 11 publications

Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

Drainage Performance of a Novel Catheter Designed to Reduce Drainage Catheter Failure

Percutaneous cholecystostomy in the management of acute cholecystitis - 10 years of experience.

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