Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy in patients with moderate acute cholecystitis under antithrombotic therapy

Abstract

Percutaneous transhepatic gallbladder drainage followed by elective LC may be an effective therapeutic strategy for moderate AC in patients receiving antithrombotic therapy.

Role of percutaneous transhepatic gallbladder aspiration in the early management of acute cholecystitis

“…First, among the 147 patients in the present study, 51 (34.7%) needed re‐intervention. The high re‐intervention rate of PTGBA acts as a significant disadvantage compared with PTGBD . Second, the remaining bile juice may spill over along the puncture tract, and the risk of bleeding with PTGBA may be higher than that with PTGBD because PTGBA lacks the compression effect of the tube.…”

Outcomes of early versus delayed laparoscopic cholecystectomy for acute cholecystitis performed at a single institution

“…Third, we performed subtotal cholecystectomy for patients with severe scarring around Calot's triangle (29). PTGBD followed by DLC is useful for patients with complications or of advanced age (9,10,13,14,30). Regarding the timing of PTGBD, a recent report suggested that surgery with a short interval after PTGBD improved perioperative outcomes compared to surgery with long interval after PTGBD (31).…”

“…Similarly, DLC has been defined, for example, as surgery performed 6-12 weeks after symptom onset or 7-45 days after admission (3)(4)(5). In addition, reports vary as to whether percutaneous transhepatic gallbladder drainage (PTGBD) performed before DLC is beneficial (9)(10)(11)(12)(13)(14).…”

Evaluating the timing of laparoscopic cholecystectomy for acute cholecystitis in an experienced center based on propensity score matching

“…TG13 defined moderate AC as the consistent presence of symptoms for more than 72 h and recommended GB drainage as the initial therapy for these patients . As such, particularly in Japan, GB drainage has generally been preferred as the first‐line therapy for moderate AC patients, followed by DLC .…”

“…TG13 defined moderate AC as the consistent presence of symptoms for more than 72 h and recommended GB drainage as the initial therapy for these patients (3). As such, particularly in Japan, GB drainage has generally been preferred as the first-line therapy for moderate AC patients, followed by DLC (29,30). For large population-based studies, measurement of the timing of surgery may be more accurate if it is based on the time from presentation rather than from symptom onset.…”