Gallbladder Cryoablation: A Novel Option for High-Risk Patients with Gallbladder Disease

McNiel, David; Hennemeyer, Charles; Woodhead, Greg; McGregor, Hugh

doi:10.1016/j.amjmed.2020.10.007

Cited by 7 publications

(4 citation statements)

References 20 publications

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“…The cryogenic technologies application in the complex treatment of gallbladder adenocarcinoma tectomy and endobiliary drainage [6]. In addition, one of the advantages of the cryosurgical method is the possibility of its application close to the major blood vessels [5].…”

Section: Discussionmentioning

confidence: 99%

The Cryogenic Technologies Application in the Complex Treatment of Gallbladder Adenocarcinoma With Invasion Into the Portal Vein Branches: Case Report

Dronov,

Kozachuk,

Bakunets

et al. 2023

Exp. oncol.

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The right trisectionectomy is the main treatment modality for locally advanced gallbladder cancer with invasion of the intraparenchymal portal vein branches because it allows the achievement of negative resection margins (R0). However, only 10%—25% of such patients are eligible for surgery. The cryosurgical method has been successfully used in the complex treatment of hepatopancreatobiliary malignant neoplasms for many years. The possibility of its application close to major blood vessels is one of its advantages. In the presented case, the cryodestruction of the residual tumor with invasion into the anterior wall of the left branch of the portal vein was used as a debulking option during liver resection (R2) due to locally advanced gallbladder cancer. The cryodestruction was performed with application method with a double cryocycle and spontaneous thawing using a Cryo-Pulse device and liquid nitrogen as a cryoagent. No postoperative complications related to cryodestruction were noted. The cryogenic technologies application in the debulking surgery of gallbladder cancer can be a safe treatment modality for residual tumors with invasion into the intraparenchymal branches of the portal vein.

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Section: Discussionmentioning

confidence: 99%

The Cryogenic Technologies Application in the Complex Treatment of Gallbladder Adenocarcinoma With Invasion Into the Portal Vein Branches: Case Report

Dronov,

Kozachuk,

Bakunets

et al. 2023

Exp. oncol.

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“…36 Encouragingly, a prospective clinical trial has now been initiated. 37 A second group also demonstrated a case of successful gallbladder cryoablation in a 65-year-old man with a slightly varied technique; after gaining access with guide wire/ directional catheter via previously placed percutaneous cholecystostomy drainage catheter, an endovenous laser system was positioned in the cystic duct and laser ablation of the cystic duct was performed. Gallbladder cryoablation was then performed 6 weeks later with the 4-week follow-up CT demonstrating a completely shrunken gallbladder.…”

Section: Gallbladder Ablationmentioning

confidence: 99%

Percutaneous Interventions for Symptomatic Cholelithiasis and Acute Cholecystitis

Ragulojan

Fradkin

D’Souza

2022

Digestive Disease Interventions

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Laparoscopic cholecystectomy is considered the standard treatment option for symptomatic cholelithiasis and acute cholecystitis. However, in non-surgical candidates or patients meeting criteria of severe presentation, percutaneous cholecystostomy is the recommended approach to management, generally with the intent of eventual cholecystectomy. Should interval cholecystectomy not be an option, additional novel percutaneous techniques for stone extraction and/or gallbladder ablation have shown success in the recent literature and, along with cholecystostomy, are presented in this review.

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“…

We read with great interest the review on novel cryoablation therapy for cholecystitis by McNiel et al 1 Surgical cholecystectomy is the gold standard of treatment for acute cholecystitis according to recently updated Tokyo guidelines. 2 We agree with McNiel et al that a definitive management of cholecystitis in patients who are not surgical candidates remains a significant clinical need.Traditionally, percutaneous cholecystostomy drainage (PCD) is performed when patients are considered poor surgical candidates.

…”

mentioning

confidence: 99%

“…Recent studies comparing the outcomes of EUS-GBD using lumenapposing metal stents with percutaneous cholecystostomy have reported results favoring EUS-GBD because of lower rates of adverse events with excellent long-term outcomes. 1,6 According to an international survey, patients overwhelmingly prefer an internal biliary drainage over a percutaneous drain. 7 Endoscopic ultrasound-guided drainage has evolved as a minimally invasive, definitive treatment option for management of cholecystitis in patients who are not surgical candidates.…”

mentioning

confidence: 99%

Gallbladder Cryoablation: Other Endoscopic Options for High-Risk Patients with Cholecystitis

Jones

Aslanian

Muniraj

2021

The American Journal of Medicine

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We read with great interest the review on novel cryoablation therapy for cholecystitis by McNiel et al. 1 Surgical cholecystectomy is the gold standard of treatment for acute cholecystitis according to recently updated Tokyo guidelines. 2 We agree with McNiel et al that a definitive management of cholecystitis in patients who are not surgical candidates remains a significant clinical need.Traditionally, percutaneous cholecystostomy drainage (PCD) is performed when patients are considered poor surgical candidates. If there is no improvement of surgical candidacy, then PCD remains as a permanent drain. Percutaneous cholecystostomy drainage has many potential risks such as bleeding, bile leak, tube dislodgement, pain at the insertion site, cosmetic issues, and decreased quality of life.Although, as stated by McNeil et al, 1 cryoablation offers a novel method, this still requires PCD with several sessions with uncertain benefits at this stage.Endoscopic transpapillary gallbladder drainage via endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided transmural gallbladder drainage (EUS-GBD) are two other minimally invasive alternative techniques for gallbladder drainage. Over the past few years, there has been progress in the EUS-GBD technique, including use of covered self-expanding metal stents and lumen-apposing metal stents. 3 Endoscopic ultrasound-guided transmural gallbladder drainage with creation of cholecystoduodenostomy or cholecystogastrostomy is a minimally invasive option for patients with cholecystitis who are poor surgical candidates. Previous studies have shown that EUS-GBD can sustain and improve quality of life when compared with PCD. 4 Endoscopic ultrasound-guided transmural gallbladder drainage offers a potential cost-saving benefit and morbidity benefit by demonstrating a decreased number of repeat interventions. Our group demonstrated that EUS-GBD is safer even in high-cirrhotic patients with low platelet counts. 5 The special design of the stent used in this procedure aids in good apposition of gallbladder to duodenum and stomach and reduces the risk of adverse events. Recent studies comparing the outcomes of EUS-GBD using lumenapposing metal stents with percutaneous cholecystostomy have reported results favoring EUS-GBD because of lower rates of adverse events with excellent long-term outcomes. 1,6 According to an international survey, patients overwhelmingly prefer an internal biliary drainage over a percutaneous drain. 7 Endoscopic ultrasound-guided drainage has evolved as a minimally invasive, definitive treatment option for management of cholecystitis in patients who are not surgical candidates.

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Gallbladder Cryoablation: A Novel Option for High-Risk Patients with Gallbladder Disease

Cited by 7 publications

References 20 publications

The Cryogenic Technologies Application in the Complex Treatment of Gallbladder Adenocarcinoma With Invasion Into the Portal Vein Branches: Case Report

The Cryogenic Technologies Application in the Complex Treatment of Gallbladder Adenocarcinoma With Invasion Into the Portal Vein Branches: Case Report

Percutaneous Interventions for Symptomatic Cholelithiasis and Acute Cholecystitis

Gallbladder Cryoablation: Other Endoscopic Options for High-Risk Patients with Cholecystitis

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