Pilot Study of the Safety and Efficacy of Gallbladder Cryoablation in a Porcine Model: Midterm Results

McGregor, Hugh; Surman, Andrew M.; Fernandez, A; Saeed, Maythem; Wilson, Mark W.; Hetts, Steven W.; Conrad, Miles

doi:10.1016/j.jvir.2017.10.020

Cited by 9 publications

(5 citation statements)

References 9 publications

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“…Cryoablation of the gallbladder is another exciting potential method of gallbladder ablation. 48,49 In 2020, McGregor et al reported the 1 year outcomes of six patients who underwent percutaneous cryoablation, showing gallbladder involution in five out of six patients and asymptomatic distention of the gallbladder in the remaining patient. 50 Of note, one patient could not receive gallbladder cryoablation due to adhesions preventing safe thermal ablation.…”

Section: Gallbladder Ablationmentioning

confidence: 99%

Gallbladder Drainage: IR and GI Perspective

Vezeridis,

Satyavada,

Barakat

2023

Digestive Disease Interventions

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Cholecystitis and gallbladder disease are an important, growing, and costly problem. As interventional radiology (IR) and gastroenterology (GI) have evolved and become even more minimally invasive and technically capable, we play an increasingly important role in the management of cholecystitis, particularly in nonsurgical and palliative settings. This review highlights the modern and future role of IR and GI in gallbladder drainage for the management of acute cholecystitis.

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Section: Gallbladder Ablationmentioning

confidence: 99%

Gallbladder Drainage: IR and GI Perspective

Vezeridis,

Satyavada,

Barakat

2023

Digestive Disease Interventions

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“…2). [25][26][27] Despite this promising early evidence, further studies confirming cystic duct occlusion are required.…”

Section: Potential Advantages Of Gallbladder Cryoablationmentioning

confidence: 99%

“…2). [25][26][27] Nonetheless, a patent cystic duct could result in a bile leak after cryoablation or repopulation of the gallbladder mucosa and recurrent disease. This has led investigators to use laser ablation as an adjunct to occlude the cystic duct prior to cryoablation.…”

Section: Challengesmentioning

confidence: 99%

“…Preclinical studies in swine were performed prior to clinical application of gallbladder cryoablation. 26,28 Acute studies demonstrated transmural ablation with complete denudation of the gallbladder epithelium and necrosis of the muscularis with ablation temperatures of À20 °C or lower (►Fig. 3).…”

Section: Gallbladder Cryoablation: Preclinical and Early Clinical Stu...mentioning

confidence: 99%

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Gallbladder Cryoablation: Clinical and Technical Considerations

McGregor

2022

Digestive Disease Interventions

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As many as 500,000 cholecystectomies are performed per year in the United States. Frail patients are at higher risk from cholecystectomy, with reported postoperative complication and mortality rates as high as 31 and 5% in patients older than 75 years. Percutaneous cholecystostomy drainage is commonly employed in high-risk patients with cholecystitis, with over 12,000 cases performed annually. Cholecystostomy, however, is not a definitive treatment, with up to 30% of patients having a recurrent episode of cholecystitis within 4 months after tube removal. Gallbladder cryoablation has emerged as a minimally invasive procedure that achieves transmural gallbladder wall necrosis in a single session resulting in gallbladder fibrosis and involution. Early clinical data have been promising, with reported technical success of 86% and clinical success of 100% at up to 500 days of follow-up. Several challenges and unknowns remain, however, including optimal patient selection and procedural technique, the potential need for adjunct procedures to occlude the cystic duct, the implications of the immunostimulatory effects of cryoablation, and the impact of the presence of gallstones on outcomes. This article reviews the rationale behind gallbladder cryoablation, updates early clinical outcomes, and discusses the challenges that remain for the adoption of the technique for the treatment of benign gallbladder disease.

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“…A recent article published by McGregor et al from the University of Arizona has taken a completely different approach-percutaneous devitalization of the gallbladder and cystic duct via cryoablation. 46,47 They reported a case series of seven patients who underwent percutaneous cryoablation of the gallbladder after percutaneous cholecystostomy placement for acute cholecystitis. The patients had a mean American Society of Anesthesiologists (ASA) classification of 3.67, and the selected patients had severe medical comorbidities including cirrhosis, chronic obstructive pulmonary disease, obstructive sleep apnea, recent myocardial infarction, and others.…”

Section: Gallbladder Ablationmentioning

confidence: 99%

Gallbladder: Role of Interventional Radiology

Antalek

Riaz

Nemcek

2021

Semin intervent Radiol

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Percutaneous cholecystostomy is an established procedure for the management of patients with acute cholecystitis and with significant medical comorbidities that would make laparoscopic cholecystectomy excessively risky. In this review, we will explore the role of percutaneous cholecystostomy in the management of acute cholecystitis as well as other applications in the management of biliary pathology. The indications, grading, technical considerations, and postprocedure management in the setting of acute cholecystitis are discussed. In addition, we will discuss the potential role of percutaneous cholecystostomy in the management of gallstones and biliary strictures, in establishing internal biliary drainage, and in a joint setting with other clinicians such as gastroenterologists in the management of complex biliary pathology.

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Pilot Study of the Safety and Efficacy of Gallbladder Cryoablation in a Porcine Model: Midterm Results

Cited by 9 publications

References 9 publications

Gallbladder Drainage: IR and GI Perspective

Gallbladder Drainage: IR and GI Perspective

Gallbladder Cryoablation: Clinical and Technical Considerations

Gallbladder: Role of Interventional Radiology

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