Assessment of Gallbladder Drainage Methods in the Treatment of Acute Cholecystitis: A Literature Review

Bozic, Dorotea; Ardalic, Zarko; Mestrovic, Antonio; Bilandzic Ivisic, Josipa; Alicic, Damir; Zaja, Ivan; Ivanovic, Tomislav; Bozic, Ivona; Puljiz, Zeljko; Bratanic, Andre

doi:10.3390/medicina60010005

Cited by 5 publications

(4 citation statements)

References 100 publications

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“…An alternative endoscopic approach for GBD is based on ERCP with selective cannulation of the cystic duct and a transpapillary stent placement. In particular, this approach should be preferred in patients requiring ERCP for concurrent choledocholithiasis [5,86,91].…”

Section: Gallbladder Drainagementioning

confidence: 99%

The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

Mencarini,

Vestito,

Zagari

et al. 2024

JCM

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Acute cholecystitis (AC), generally associated with the presence of gallstones, is a relatively frequent disease that can lead to serious complications. For these reasons, AC warrants prompt clinical diagnosis and management. There is general agreement in terms of considering early laparoscopic cholecystectomy (ELC) to be the best treatment for AC. The optimal timeframe to perform ELC is within 72 h from diagnosis, with a possible extension of up to 7–10 days from symptom onset. In the first hours or days after hospital admission, before an ELC procedure, the patient’s medical management comprises fasting, intravenous fluid infusion, antimicrobial therapy, and possible administration of analgesics. Additionally, concomitant conditions such as choledocholithiasis, cholangitis, biliary pancreatitis, or systemic complications must be recognized and adequately treated. The importance of ELC is related to the frequent recurrence of symptoms and complications of gallstone disease in the interval period between the onset of AC and surgical intervention. In patients who are not eligible for ELC, it is suggested to delay surgery at least 6 weeks after the clinical presentation. Critically ill patients, who are unfit for surgery, may require rescue treatments, such as percutaneous or endoscopic gallbladder drainage (GBD). A particular treatment approach should be applied to special populations such as pregnant women, cirrhotic, and elderly patients. In this review, we provide a practical diagnostic and therapeutic approach to AC, even in specific clinical situations, based on evidence from the literature.

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Section: Gallbladder Drainagementioning

confidence: 99%

The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

Mencarini,

Vestito,

Zagari

et al. 2024

JCM

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“…However, a considerable number of patients are not eligible for surgery. PGBD, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD), and endoscopic transpapillary gallbladder drainage (ETGBD) are minimally invasive alternatives that can be considered [43][44][45]. While endoscopic approaches require equipment and expertise, PGBD is relatively easy to perform and is recommended for these patients in various guidelines [45][46][47][48][49][50].…”

Section: Percutaneous Gall Bladder Drainage (Pgbd or Percutaneous Cho...mentioning

confidence: 99%

“…Taking into consideration the diversity of allocation criteria for PGBD, success and recurrence rates have to be interpreted cautiously. PGBD is considered a rescue therapy for patients not eligible for surgery; therefore, rates of adverse events should not be compared to those of the standard therapy (cholecystectomy) but to adverse event rates after EUS-GBD and ETGBD [44]. The data analysed in recent meta-analyses are predominantly from retrospective studies.…”

Section: Percutaneous Gallbladder Drainagementioning

confidence: 99%

Ultrasound-Guided Interventions in the Biliary System

Müller,

Braden

2024

Diagnostics

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Ultrasound guidance in biliary interventions has become the standard tool to facilitate percutaneous biliary drainage as well as percutaneous gall bladder drainage. Monitoring of the needle tip whilst penetrating the tissue in real time using ultrasound allows precise manoeuvres and exact targeting without radiation exposure. Without the need for fluoroscopy, ultrasound-guided drainage procedures can be performed bedside as a sometimes life-saving procedure in patients with severe cholangitis/cholecystitis when they are critically ill in intensive care units and cannot be transported to a fluoroscopy suite. This article describes the current data background and guidelines and focuses on specific sonographic aspects of both the procedures of percutaneous biliary drainage and gallbladder drainage.

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“…The definitive treatment of AC is represented by cholecystectomy or, in the case of high-risk patients, by percutaneous cholecystostomy performed by interventional radiologists or gallbladder drainage through endoscopic procedures [35][36][37]. Definitive treatment of AC (operative vs conservative) depends on the time since the onset of symptoms, the patient's comorbidities, and clinical presentation [38,39].…”

Section: Treatmentmentioning

confidence: 99%

Updates on Antibiotic Regimens in Acute Cholecystitis

Fico,

La Greca,

Tropeano

et al. 2024

Medicina

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Acute cholecystitis is one of the most common surgical diseases, which may progress from mild to severe cases. When combined with bacteremia, the mortality rate of acute cholecystitis reaches up to 10–20%. The standard of care in patients with acute cholecystitis is early laparoscopic cholecystectomy. Percutaneous cholecystostomy or endoscopic procedures are alternative treatments in selective cases. Nevertheless, antibiotic therapy plays a key role in preventing surgical complications and limiting the systemic inflammatory response, especially in patients with moderate to severe cholecystitis. Patients with acute cholecystitis have a bile bacterial colonization rate of 35–60%. The most frequently isolated microorganisms are Escherichia coli, Klebsiella spp., Streptococcus spp., Enterococcus spp., and Clostridium spp. Early empirical antimicrobial therapy along with source control of infection is the cornerstone for a successful treatment. In these cases, the choice of antibiotic must be made considering some factors (e.g., the severity of the clinical manifestations, the onset of the infection if acquired in hospital or in the community, the penetration of the drug into the bile, and any drug resistance). Furthermore, therapy must be modified based on bile cultures in cases of severe cholecystitis. Antibiotic stewardship is the key to the correct management of bile-related infections. It is necessary to be aware of the appropriate therapeutic scheme and its precise duration. The appropriate use of antibiotic agents is crucial and should be integrated into good clinical practice and standards of care.

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Assessment of Gallbladder Drainage Methods in the Treatment of Acute Cholecystitis: A Literature Review

Cited by 5 publications

References 100 publications

The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach

Ultrasound-Guided Interventions in the Biliary System

Updates on Antibiotic Regimens in Acute Cholecystitis

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