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

Komatsu, Shohei; Tsukamoto, Tadashi; Iwasaki, Takeshi; Toyokawa, Akihiro; Hasegawa, Yasuhisa; Tsuchida, Shinobu; Takahashi, Tsuyoshi; Takebe, Atsushi; Wakahara, Tomoyuki; Watanabe, Akihiko; Sugahara, Atsushi; Mukai, Hidekazu

doi:10.1111/1751-2980.12198

Cited by 21 publications

(23 citation statements)

References 27 publications

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“…Repetitive PGBA (2-4 times) was reported in four studies, including two that used antibiotic instillation, and had clinical success rates of 76% to 96% and complication rates of 0% to 3%. Th e two studies with antibiotic instillation had clinical success rates of 95% and 96% ( 7,8 ), and the other two studies without antibiotic instillation had clinical success rates of 76% and 92% ( 9, 10 ). Repetitive PGBAs had success rates of 47% to 96% in patients who did not improve with a single PGBA (7)(8)(9)(10).…”

Section: Resultsmentioning

confidence: 97%

“…Single PGBA had success rates of 50% to 93% and complication rates of 0% to 4%. Two single PGBA studies reported serious adverse events from gallbladder aspiration, which included intraabdominal hemorrhage, bile leakage, gallbladder hemorrhage, and peritonitis ( 8,10 ). Repetitive PGBA (2-4 times) was reported in four studies, including two that used antibiotic instillation, and had clinical success rates of 76% to 96% and complication rates of 0% to 3%.…”

Section: Resultsmentioning

confidence: 99%

“…Th is limited our ability to make specifi c comparisons. Two studies used antibiotic instillation in addition to PGBA ( 7,8 ). We report the comparison of eff ectiveness and complications between PGBA and PC, the comparison of eff ectiveness and complications between single PGBA and repetitive PGBA, and other outcomes, including salvage PC, urgent surgery, and pain control.…”

Section: Methodsmentioning

confidence: 99%

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Percutaneous Gallbladder Aspiration for Acute Cholecystitis

Rassameehiran¹,

Tantrachoti²,

Nugent³

2016

Baylor University Medical Center Proceedings

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Percutaneous Gallbladder Aspiration for Acute Cholecystitis

Rassameehiran¹,

Tantrachoti²,

Nugent³

2016

Baylor University Medical Center Proceedings

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“…(24,25,26) However, recently the usefulness of PTGBA has been reported. (27,28,29) Previously in our hospital PTGBD were performed in principle for AC. In fact the effect of drainage of PTGBD is superior to that of PTGBA.…”

Section: Discussion Discussionmentioning

confidence: 99%

An Investigation of the Optimal Timing of Surgery after Preoperative Gallbladder Drainage for Acute Cholecystitis

Ueno¹,

Ajiki²,

Kominami³

et al. 2017

SGO

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Background: The optimal timing of surgery is still controversial when preoperative gallbladder drainage (PGD) has been performed for AC. Method: Between 2010 and 2015, 77 AC patients, who consecutively underwent surgery, were divided into two groups. One was the group on which PGD were performed (n=39), and the other was patients that underwent emergency operations (EO) without PGD (n=38). The PGD group was further divided into two groups: one with the period from drainage to surgery of ≦14 days (PGD-E：n=17) and in the other the period was ＞14 days (PGD-D：n=22). The surgical outcomes were compared between these groups. Results: The blood loss of the PGD group was significantly less (159.7/354.3 ml : p=0.028) compared to the EO group. In the PGD-E group the total hospital stay was significantly shorter than that of the PGD-D group (29/40.8 days : p=0.041). There were no significant differences between PGD and EO when limited to patients who underwent laparoscopic cholecystectomy (LC). Conclusion: Surgery within 14 days after PGD might be as safe as surgery over 14 days after PGD. With regard to shortening the total hospital stay, surgery within 14 days after PGD might be recommendable.

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“…Gallbladder infection may also spread to the liver or pericholecystic cavity and lead to the development of liver abscesses or peritonitis, respectively (2)(3)(4). Therefore, prompt treatment with cholecystectomy, percutaneous transhepatic gallbladder drainage or aspiration is typically recommended following diagnosis of acute cholecystitis (5)(6)(7). Accurate diagnosis is also critical for the appropriate management of acute cholecystitis (8).…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression/T2 image fusion for the diagnosis of acute cholecystitis

Tomizawa

Shinozaki

Tanaka

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Prompt and accurate diagnosis is critical in the treatment of acute cholecystitis. Diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression/T2 image fusion (DWIBS/T2) identifies areas with high signal intensity, corresponding to inflammation. In the present study, the records and images of patients with acute cholecystitis who underwent DWIBS/T2 between January 2013 and March 2014 were retrospectively analyzed. A total of 11 patients with acute cholecystitis were enrolled. In one patient, DWIBS/T2 identified a thickened wall and high signal intensity, with high signal intensity in the pericholecystic space that suggested localized peritonitis. Positive DWIBS/T2 results indicating acute cholecystitis were obtained in 10/11 patients, with a sensitivity of 90.9%. In addition, wall thickening and high signal intensity were absent in DWIBS/T2 images when wall thickening was not detected by computed tomography. Wall thickening and high signal intensity was attenuated when patients with acute cholecystitis were clinically treated. These data suggest that a thickened gallbladder wall and high signal intensity are indicative of acute cholecystitis and that DWIBS/T2 may be a useful technique in evaluating the severity of acute cholecystitis. IntroductionAcute cholecystitis is characterized by inflammation of the gallbladder and typically occurs due to obstruction of the gallbladder neck or cystic duct by a gallstone (1). Gallbladder infection may also spread to the liver or pericholecystic cavity and lead to the development of liver abscesses or peritonitis, respectively (2-4). Therefore, prompt treatment with cholecystectomy, percutaneous transhepatic gallbladder drainage or aspiration is typically recommended following diagnosis of acute cholecystitis (5-7). Accurate diagnosis is also critical for the appropriate management of acute cholecystitis (8).Diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression (DWIBS) is based on a diffusion-weighted imaging (DWI) technique, which enables visualization of the random movement of water molecules (Brownian motion) for diagnostic imaging (9). Images are acquired with DWIBS during free breathing of the patient through the use of multiple-signal averaging, fat suppression and heavy diffusion weighting (10). In particular, a high signal intensity of DWIBS is a positive indicator of cancer and inflammation. An advantage of DWIBS over DWI is that it exhibits positive signals with strong contrast against surrounding normal tissues. However, the evaluation of positive signals to obtain anatomical information becomes difficult when signals in the surrounding tissues are suppressed (11,12). Images obtained from DWIBS are fused with their corresponding T2-weighted images using a workstation (13-15). DWIBS and T2-weighted image fusion (DWIBS/T2) enables anatomical evaluation of the positive signals obtained from DWIBS (16). Therefore, the present study retrospectively analyzed images obtained by DWIB...

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

Abstract: The present study demonstrated the safety and acceptability of treatment with PTGBA for AC at our center. This elective treatment strategy may be a useful alternative option in the treatment of AC.

Cited by 21 publications

References 27 publications

Percutaneous Gallbladder Aspiration for Acute Cholecystitis

Percutaneous Gallbladder Aspiration for Acute Cholecystitis

An Investigation of the Optimal Timing of Surgery after Preoperative Gallbladder Drainage for Acute Cholecystitis

Diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression/T2 image fusion for the diagnosis of acute cholecystitis

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