Usefulness of single and repetitive percutaneous transhepatic gallbladder aspiration for the treatment of acute cholecystitis

Abstract

For the treatment of acute cholecystitis that does not react to conservative therapies, PTGBA is a safe, simple, and effective treatment modality that can be performed at bedside without any severe complications.

Percutaneous Gallbladder Aspiration for Acute Cholecystitis

“…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).…”

“…Th e complication rate was 0% ( 3,6,9 ). One randomized controlled study and six observational studies reported that 0% to 43% of patients required salvage PC and 0% to 7% of patients required surgery, either due to lack of improvement of symptoms, patient preference, or procedure-related complications ( 3,4,(6)(7)(8)(9)(10). Two observational studies reported immediate pain control rates of 99% to 100% ( 9, 10 ).…”

“…Th e methods used in these studies included single and repetitive PGBA with needle gauges ranging from 18 to 21 ( 3,4,(6)(7)(8)(9)(10). Th is limited our ability to make specifi c comparisons.…”

“…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.…”

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

“…(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.…”