Optimal timing of cholecystectomy after percutaneous gallbladder drainage for severe cholecystitis

Inoue, Koetsu; Ueno, Takayoshi; Nishina, Orie; Douchi, Daisuke; Shima, Kazunari; Goto, Shinji; Takahashi, Masae; Shibata, Chikashi; Naitö, Hiroo

doi:10.1186/s12876-017-0631-8

Cited by 52 publications

(34 citation statements)

References 28 publications

(28 reference statements)

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“…In the study by Altieri et al[ 23 ] of 2998 patients who underwent cholecystectomy following PC, 47 (1.6%) patients experienced common bile duct injury. Some studies suggest that risks may be increased further when LC is performed at an early stage after PHGD in high-risk patients[ 24 ]. El-Gendi et al[ 13 ] and Ke and Wu[ 25 ] reported good outcomes when LC was performed after waiting 4-6 wk after PHGD.…”

Section: Discussionmentioning

confidence: 99%

Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

Liu¹,

Wu²,

Zhu³

et al. 2020

WJG

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BACKGROUND B-mode-ultrasound-guided percutaneous cholecystostomy (PC) may be performed by a transhepatic or transperitoneal approach, called percutaneous transhepatic gallbladder drainage (PHGD) and percutaneous transperitoneal gallbladder drainage (PPGD), respectively. We compared the impact of PC related to the route of catheter placement on subsequent laparoscopic cholecystectomy (LC). AIM To compare the impact of PC related to the route of catheter placement on subsequent LC. METHODS We retrospectively studied 103 patients with acute calculous cholecystitis who underwent scheduled LC after PC between January 2010 and January 2019. Group I included 58 patients who underwent scheduled LC after PHGD. Group II included 45 patients who underwent scheduled LC after PPGD. Clinical outcomes were analyzed according to each group. RESULTS Baseline demographic characteristics did not differ significantly between both groups ( P > 0.05). Both PHGD and PPGD were able to quickly resolve cholecystitis sepsis. Group I showed significantly higher efficacy than group II in terms of lower pain score during puncture (3.1 vs 4.5; P = 0.001) and at 12 h follow-up (1.5 vs 2.2; P = 0.001), lower rate of fever within 24 h after PC (13.8% vs 42.2%; P = 0.001), shorted operation duration (118.3 vs 139.6 min; P = 0.001), lower amount of intraoperative bleeding (72.1 vs 109.4 mL; P = 0.001) and shorter length of hospital stay (14.3 d vs 18.0 d; P = 0.001). However, group II had significantly lower rate of local bleeding at the PC site (2.2% vs 20.7%; P = 0.005) and lower rate of severe adhesion (33.5% vs 55.2%; P = 0.048). No significant differences were noted between both groups regarding the conversion rate to laparotomy, rate of subtotal cholecystectomy, complications and pathology. CONCLUSION B-mode-ultrasound-guided PHGD is superior to PPGD followed by LC for treatment of acute calculous cholecystitis, with shorter operating time, minimal amount of intraoperative bleeding and short length of hospital stay.

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Section: Discussionmentioning

confidence: 99%

Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

Liu¹,

Wu²,

Zhu³

et al. 2020

WJG

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“…Because most studies (15)(16)(17) figure out the short interval increases intraoperative difficulty, we require all patients to undergo cholecystectomy 3 months after drainage, so that edema and inflammation around the gallbladder subsided completely.…”

Section: Interventionsmentioning

confidence: 99%

Randomized controlled trial of laparoscopic cholecystectomy after ENGBD versus PTGBD in acute cholecystitis: the LCEVP study protocol

Mu¹,

Yue²,

Li³

et al. 2019

Preprint

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Background Transitional drainage which is followed by cholecystectomy plays a key role in the management of acute cholecystitis, especially in high-risk surgical patients. Endoscopic naso-gallbladder drainage (ENGBD) is an alternative to percutaneous transhepatic gallbladder drainage (PTGBD) for patients who need temporary drainage. There is a lack of prospective comparison on the relevant outcomes of the two drainage methods during the period of drainage, especially the subsequent cholecystectomy.Methods This is a randomised controlled two arm double-blind singer center trial. Patients with acute cholecystitis undergo emergent or early cholecystectomy and need drainage will be randomly assigned to group PTGBD or ENGBD. Pain score is defined as the primary endpoint, whereas several secondary endpoints such as the rates of technical success, clinical remission, open conversion of cholecystectomy will be determined to elucidate more detailed differences between two groups. The general feasibility, safety and quality checks required for high quality evidence will be adhered to.Discussion This study would provide the first type A evidence concerning the comparison of ENGBD versus PTGBD in surgically high-risk patients with acute cholecystitis, it will be the first trial designed to determine the impact of two drainage methods on not only peri-drainage but also peri-LC.Trial registration NCT03701464. Registered on 10 Octomber 2018.

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“…The patients who need surgery intervention are suggested to be evaluated using the Charlson Comorbidity Index (CCI) [18][19][20] or the American Society of Anesthesiologists physical status classi cation (ASA-PS) [21,22]; PT-GBD is useful for managing high surgical risk patients compared with conservative treatment [9,23,24]. CCY can decrease further recurrent biliary events (RBEs) [25,26], while the surgery timing after patients with acute cholecystitis have undergone PT-GBD is still in debate [27][28][29][30][31][32]. Currently, there is no strong evidence to suggest who has survival bene ts from subsequent CCY after initial PT-GBD, but a similar concept in choledocholithiasis demonstrated that a prophylactic CCY in acute cholangitis patients who underwent sphincterotomy showed survival bene t compared to the wait-and-see approach [33].…”

Section: Introductionmentioning

confidence: 99%

Subsequent Cholecystectomy Is The Most Important Factor for Recurrent Biliary Event-Free Survival in High-Risk Acute Cholecystitis Patients after Gallbladder Drainage

Wang¹,

Tsai²,

Huang³

et al. 2020

Preprint

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Background and Aims: Cholelithiasis is a disease with increasing prevalence over the decades. Gallbladder drainage is an alternative choice in critically ill patients who cannot tolerate early surgery for acute cholecystitis. In previous data, early or delayed cholecystectomy leads to less recurrent biliary events comparing to using a wait-and-see strategy. We wondered if the subsequent cholecystectomy strategy is the most important factor to improve recurrent biliary event-free survival after gallbladder drainage. The present study aimed to explore the most important factor to improve the clinical outcome after percutaneous transhepatic gallbladder drainage.Methods: We studied 211 adult acute cholecystitis patients who received percutaneous transhepatic gallbladder drainage during index admission between July 2017 and December 2018 in Chung Shan Medical University Hospital and Changhua Christian Hospital. Patients who died during the index admission or lost follow-up within 30 days were excluded. We further divided these patients into those who received subsequent cholecystectomy within 2 months and those who received no cholecystectomy within 2 months. Recurrent biliary events, mortality and biliary event-related mortality were compared. Multivariate analysis was applied to find the most important factors of recurrent biliary event-free survival.Results: There were 8 cases (13.6%) in the subsequent cholecystectomy group that experienced recurrent biliary events, while 39 cases (32.2%) experienced recurrent biliary events in the no cholecystectomy within 2 months group. The proportion and average recurrent biliary events per person were all significantly lower in the subsequent cholecystectomy group. The recurrent biliary event-related mortality difference is insignificant. The most decisive factor to determine recurrent biliary event-free survival is whether a subsequent cholecystectomy performed or not (HR:0.485, 95% CI: 0.250-0.941, p=0.032).Conclusion: Subsequent cholecystectomy can decrease further recurrent biliary events and improve recurrent biliary event-free survival in high risk patients with acute cholecystitis that accepted percutaneous transhepatic gallbladder drainage initially.

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Optimal timing of cholecystectomy after percutaneous gallbladder drainage for severe cholecystitis

Cited by 52 publications

References 28 publications

Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

Randomized controlled trial of laparoscopic cholecystectomy after ENGBD versus PTGBD in acute cholecystitis: the LCEVP study protocol

Subsequent Cholecystectomy Is The Most Important Factor for Recurrent Biliary Event-Free Survival in High-Risk Acute Cholecystitis Patients after Gallbladder Drainage

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