Cystic Duct Embolization with Chemical Gallbladder Ablation for the Treatment of Acute Calculous Cholecystitis in High-Risk Patients: A Prospective Single-Center Study

Endoscopic Transpapillary Gallbladder Drainage for Recurrent Cholecystitis after Covered Self-expandable Metal Stent Placement for Unresectable Malignant Biliary Obstruction

“…Nakahara et al ( 5 ) reported that the PTGBD tube could not be removed until death in 3 of 6 (50%) patients who underwent PTGBD for cholecystitis after SEMS placement owing to the recurrence of cholecystitis after tube clamping (n=2) and the appearance of ascites (n=1). Several studies have investigated chemical ablation of the gallbladder mucosa through the injection of ethanol or Aethoxysklerol as an alternative to permanent PTGBD ( 6 - 8 ); however, this technique has not been well evaluated because only case series studies have been performed. In addition, PTGBD has a general disadvantage in that it is contraindicated in the presence of a bleeding tendency due to antiplatelet/anticoagulant use or thrombocytopenia, massive ascites, or an anatomically inaccessible location of the gallbladder ( 9 ).…”

Gallbladder Drainage: IR and GI Perspective

“…Both thermal and chemical ablative techniques have been performed without gallstone removal. 47 49 50 Therefore, if they are proven to be clinically successful in larger and prospective studies, gallbladder ablation may obviate or reduce the need for percutaneous gallstone extraction.…”

Percutaneous Interventions for Symptomatic Cholelithiasis and Acute Cholecystitis

“…Historically, there have been several studies that have investigated the feasibility of gallbladder ablation in animal models and human cholecystitis patients with various chemical agents, such as acetic acid, alcohol, and sodium hypochlorite as well as heat and laser modalities, occasionally with pre-ablation cystic duct embolization. 27 28 29 30 31 32 Some of these studies have demonstrated success, however, issues included ineffective or incomplete mucosal ablation, mucocele formation, requirement for several ablation sessions, and mucosal regeneration. 33 To our knowledge, the only multi-patient study over the last decade to investigate gallbladder chemical ablation is a prospective study of 10 acute cholecystitis patients performed recently by Atar et al 32 Patients first underwent percutaneous cholecystostomy tube replacement followed by clearance of existing bile duct stones into the duodenum before undergoing cystic duct embolization with coils.…”

“…27 28 29 30 31 32 Some of these studies have demonstrated success, however, issues included ineffective or incomplete mucosal ablation, mucocele formation, requirement for several ablation sessions, and mucosal regeneration. 33 To our knowledge, the only multi-patient study over the last decade to investigate gallbladder chemical ablation is a prospective study of 10 acute cholecystitis patients performed recently by Atar et al 32 Patients first underwent percutaneous cholecystostomy tube replacement followed by clearance of existing bile duct stones into the duodenum before undergoing cystic duct embolization with coils. A foam sclerosant (3% aethoxysklerol) was then injected into the gallbladder.…”