The Rise and Fall of Percutaneous Cholecystostomy in a Community Hospital: Is It Possible to Turn the Tide of History?

Ostapenko, Alexander; Liechty, Shawn; Manuia, Emi; Stroever, Stephanie; Casasanta, Marc; Kleiner, Daniel

doi:10.1007/s11605-021-04996-1

Cited by 2 publications

(3 citation statements)

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“…Percutaneous gallbladder drainage (PT-GBD) is the most common nonoperative method for gallbladder decompression in patients unfit for surgery. However, drain-related complications (20%–75%), including dyscosmesis, discomfort, and recurrent cholecystitis (up to 15%), limit its long-term use 5,6 . Although EUS-GBD may have similar technical and clinical success compared with percutaneous drainage, it has been reported to use fewer hospital resources, result in fewer adverse events (AEs), improve pain scores, and decrease the need for repeat gallbladder drainage 7 …”

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confidence: 99%

“…However, drain-related complications (20%-75%), including dyscosmesis, discomfort, and recurrent cholecystitis (up to 15%), limit its long-term use. 5,6 Although EUS-GBD may have similar technical and clinical success compared with percutaneous drainage, it has been reported to use fewer hospital resources, result in fewer adverse events (AEs), improve pain scores, and decrease the need for repeat gallbladder drainage. 7 Endoscopic approaches include transpapillary gallbladder drainage and EUS-GBD.…”

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confidence: 99%

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Endoscopic Ultrasound-guided Transluminal Gallbladder Drainage in Patients With Acute Cholecystitis

et al. 2022

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Objective: To evaluate the safety and efficacy of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using a lumen-apposing metal stent (LAMS). Background: For patients with acute cholecystitis who are poor surgical candidates, EUS-GBD using a LAMS is an important treatment alternative to percutaneous gallbladder drainage. Methods: We conducted a regulatory-compliant, prospective multicenter trial at 7 tertiary referral centers in the United States of America and Belgium. Thirty consecutive patients with mild or moderate acute cholecystitis who were not candidates for cholecystectomy were enrolled between September 2019 and August 2021. Eligible patients had a LAMS placed transmurally with 30 to 60-day indwell if removal was clinically indicated, and 30-day follow-up post-LAMS removal. Endpoints included days until acute cholecystitis resolution, reintervention rate, acute cholecystitis recurrence rate, and procedure-related adverse events (AEs). Results: Technical success was 93.3% (28/30) for LAMS placement and 100% for LAMS removal in 19 patients for whom removal was attempted. Five (16.7%) patients required reintervention. Mean time to acute cholecystitis resolution was 1.6±1.5 days. Acute cholecystitis symptoms recurred in 10.0% (3/30) after LAMS removal. Five (16.7%) patients died from unrelated causes. Procedure-related AEs were reported to the FDA in 30.0% (9/30) of patients, including one fatal event 21 days after LAMS removal; however, no AEs were causally related to the LAMS. Conclusions: For selected patients with acute cholecystitis who are at elevated surgical risk, EUS-GBD with LAMS is an alternative to percutaneous gallbladder drainage. It has high technical and clinical success, with low recurrence and an acceptable AE rate. Clinicaltrials.gov, Number: NCT03767881.

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Endoscopic Ultrasound-guided Transluminal Gallbladder Drainage in Patients With Acute Cholecystitis

et al. 2022

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“…Studies show that the rate of patients who did not undergo surgical treatment after the PGBD ranges from 43% to 94% [92]. Ostapenko A et al found a significant rise in the PGBD incidence from 2014 until 2018 (13.8% to 22.5%) [93].…”

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confidence: 99%

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

Bozic,

Ardalic,

Mestrovic

et al. 2023

Medicina

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Gallbladder drainage is a treatment option in high-risk surgical patients with moderate or severe acute cholecystitis. It may be applied as a bridge to cholecystectomy or a definitive treatment option. Apart from the simple and widely accessible percutaneous cholecystostomy, new attractive techniques have emerged in the previous decade, including endoscopic transpapillary gallbladder drainage and endoscopic ultrasound-guided gallbladder drainage. The aim of this paper is to present currently available drainage techniques in the treatment of AC; evaluate their technical and clinical effectiveness, advantages, possible adverse events, and patient outcomes; and illuminate the decision-making path when choosing among various treatment modalities for each patient, depending on their clinical characteristics and the accessibility of methods.

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The Rise and Fall of Percutaneous Cholecystostomy in a Community Hospital: Is It Possible to Turn the Tide of History?

Cited by 2 publications

References 20 publications

Endoscopic Ultrasound-guided Transluminal Gallbladder Drainage in Patients With Acute Cholecystitis

Endoscopic Ultrasound-guided Transluminal Gallbladder Drainage in Patients With Acute Cholecystitis

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

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