Su1359 A Clinical Comparison of Endoscopic Naso-Gallbladder Drainage Verses Percutaneous Transhepatic Gallbladder Drainage for Acute Cholecystitis

Oku, Takatomi; Miseki, Tetsuya; Horii, Toru; Masaka, Tomohiro; Sakai, Takashi

doi:10.1016/j.gie.2013.03.1012

Cited by 3 publications

(3 citation statements)

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“… 10 12 13 14 15 16 17 However, this procedure is limited in patients with severe coagulopathy, thrombocytopenia, or anatomically inaccessible gallbladders. 18 19 20 Additional associated risks include catheter dislodgment, cellulitis, pneumothorax, bleeding, fistulas, and infection. 7 10 21 22 23 Frequently, the external catheter can cause significant pain and cosmetic disfigurement that can adversely affect the patient's quality of life.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Gallbladder Drainage for Acute Cholecystitis

et al. 2015

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Background/AimsSurgery is the mainstay of treatment for cholecystitis. However, gallbladder stenting (GBS) has shown promise in debilitated or high-risk patients. Endoscopic transpapillary GBS and endoscopic ultrasound-guided GBS (EUS-GBS) have been proposed as safe and effective modalities for gallbladder drainage.MethodsData from patients with cholecystitis were prospectively collected from August 2004 to May 2013 from two United States academic university hospitals and analyzed retrospectively. The following treatment algorithm was adopted. Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and cystic duct stenting was initially attempted. If deemed feasible by the endoscopist, EUS-GBS was then pursued.ResultsDuring the study period, 139 patients underwent endoscopic gallbladder drainage. Among these, drainage was performed in 94 and 45 cases for benign and malignant indications, respectively. Successful endoscopic gallbladder drainage was defined as decompression of the gallbladder without incidence of cholecystitis, and was achieved with ERCP and cystic duct stenting in 117 of 128 cases (91%). Successful endoscopic gallbladder drainage was also achieved with EUS-guided gallbladder drainage using transmural stent placement in 11 of 11 cases (100%). Complications occurred in 11 cases (8%).ConclusionsEndoscopic gallbladder drainage techniques are safe and efficacious methods for gallbladder decompression in non-surgical patients with comorbidities.

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Section: Introductionmentioning

confidence: 99%

Endoscopic Gallbladder Drainage for Acute Cholecystitis

et al. 2015

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“…11 In such situations, LC could increase the complication rate and mortality; therefore, PTGBD is gradually being recognized as an assisted method by surgeons. 12 As reported by numerous previous studies, 13,14 PTGBD is a precise and effective method for treatment of acute complicated cholecystitis, especially for patients in whom surgical procedures are not recommended. PTGBD before LC allowed us to stabilize and prepare the patients for the procedure.…”

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confidence: 86%

Evaluation of the Safety and Efficacy of Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy for Treating Acute Complicated Cholecystitis

Jia

Liu

Tan

et al. 2018

The American Surgeon

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The rate of acute cholecystitis in patients with severe underlying diseases is currently increasing. Several studies have reported percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) as a safe and reliable therapeutic option in such patients. This study aimed to elucidate the optimal time interval between PTGBD and LC. In total, 65 patients with acute complicated cholecystitis from our hospital were divided into two groups, short-term LC (sLC) and postponed LC (pLC) group according to whether the procedure was performed within 5 days of gallbladder drainage or after 5 days, respectively. The complications after PTGBD, rate of conversion to open surgery, and complications and mortality after LC were compared between the groups. The sLC group showed significantly lesser operating time, blood loss, postoperative peritoneal drainage time, postoperative oral intake time, and complications compared to the pLC group ( P < 0.05). Other factors such as the length of hospital stay (LOS), conversion to open cholecystectomy, and mortality were not statistically significant between the groups. Combined treatment with PTGBC and sLC showed superior outcomes compared to PTGBC and pLC for acute cholecystitis in severely ill patients, thus constituting a feasible and secure treatment option in specialized centers.

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“…Percutaneous transhepatic gallbladder drainage (PTGBD) has demonstrated efficacy in temporary decompression of the gallbladder 4 5 6 PTGBD is limited by presence of severe coagulopathy, anatomically inaccessible gallbladders, and is associated with adverse events (AEs) including catheter dislodgment, cellulitis, pneumothorax, bleeding, and infection 7 8 . In addition, there is a high recurrence rate of cholecystitis if the catheter is removed 9 .…”

Section: Introductionmentioning

confidence: 99%

EUS-guided gallbladder drainage in patients with cirrhosis: results of a multicenter retrospective study

et al. 2019

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Background and study aims Cirrhosis has historically been considered a relative, if not absolute, contraindication to cholecystectomy. Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has been developed for use in non-operative candidates with cholecystitis; however, little data exist for use of the procedure in patients with cirrhosis. Patients and methods This was a retrospective series involving two large tertiary referral centers performing EUS-GBD. Patients with cirrhosis who underwent EUS-GBD for cholecystitis between August 2014 and December 2018 were identified. The primary endpoint was the rate of technical success, defined as EUS-guided placement of a lumen-apposing metal stent (LAMS) from duodenum to gallbladder. Patient demographics, procedural details, adverse events (AEs), post-procedural symptoms, and clinical success were recorded. Results Fifteen patients (9 females, 6 males) with cirrhosis underwent EUS-GBD during the study period. Mean patient age was 61 ± 17.1yrs, mean MELD-Na 15 ± 7. Etiology of cirrhosis was HCV (n = 2), alcohol (n = 4), non-alcoholic fatty liver disease (n = 8), and autoimmune hepatitis (n = 1).The technical success rate was 93.3 % and mean procedure time was 64 ± 59 minutes. Initial puncture site was duodenum (n = 11), stomach (n = 3) and jejunum (n = 1) and portion of gallbladder used for drainage was neck (n = 4) and body (n = 11). Fourteen patients went on to clinical success and two AEs occurred in this cohort. One decompensation event occurred in a patient with Child-Pugh class C disease 3 weeks post-procedure. Mean length of follow-up was 373 ± 367.3 days; one death occurred due to underlying malignancy. Conclusion EUS-GBD is safe and efficacious in managing cholecystitis in patients with Child-Pugh A and B cirrhosis who are non-operative candidates. Further studies are needed to determine optimal patient selection and procedural technique.

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Su1359 A Clinical Comparison of Endoscopic Naso-Gallbladder Drainage Verses Percutaneous Transhepatic Gallbladder Drainage for Acute Cholecystitis

Cited by 3 publications

References 0 publications

Endoscopic Gallbladder Drainage for Acute Cholecystitis

Endoscopic Gallbladder Drainage for Acute Cholecystitis

Evaluation of the Safety and Efficacy of Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy for Treating Acute Complicated Cholecystitis

EUS-guided gallbladder drainage in patients with cirrhosis: results of a multicenter retrospective study

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