What makes acute cholecystitis recur after removing the percutaneous cholecystostomy tube?

Heo, Jun; Jung, Min Kyu; Cho, Chang Min; Lee, Sang Yub; Ryeom, Hun Kyu; Chun, Jae Min; Han, Young Seok; Kwon, Hyung Jun

doi:10.1097/md.0000000000028767

Cited by 4 publications

(3 citation statements)

References 21 publications

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Section: Discussionmentioning

confidence: 99%

“…Of the 36 patients who had PTGBD removed after the improvement of cholecystitis, the incidence rate of biliary tract complications, including the recurrence of cholecystitis was as high as 22.2%. Another retrospective study by Jun et al 26 investigated 115 patients who underwent PTGBD for acute cholecystitis. After improvement of cholecystitis, patients were discharged with an indwelling PTGBD catheter and were followed up every 4–12 weeks until the removal of the catheter.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic internalization by cutting versus removal of the endoscopic transpapillary naso‐gallbladder drainage tube in preoperative management of acute cholecystitis: A retrospective multicenter cohort study

Maruta

Iwashita

Yoshida

et al. 2023

J Hepato Biliary Pancreat

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BackgroundEndoscopic transpapillary naso‐gallbladder drainage (ENGBD) has been reported to be an effective treatment option for acute cholecystitis. At our institution, ENGBD was first placed for external fistula management, and endoscopic internalization by cutting was performed, shifting to endoscopic transpapillary gallbladder stenting (EGBS) after improvement of cholecystitis. However, there has been no comparative study to define which preoperative management is better: converting ENGBD to EGBS or removing ENGBD.The study aimed to compare the incidence rate of the late adverse events (AEs) related to biliary system between shifting from ENGBD to EGBS and removal of ENGBD.MethodsWe retrospectively studied 122 patients who underwent ENGBD for acute cholecystitis between January 2010 and October 2022. The patients were divided into two groups: the cutting group (converting ENGBD to EGBS) and the removal group (removal of ENGBD). The short and late clinical outcomes were compared between groups.ResultsEndoscopic transpapillary naso‐gallbladder drainage was successfully placed in 78.6% (96/122), and elective cholecystectomy was performed in 31 and 36 patients in the cutting and removal groups, respectively. The cumulative late‐AE rates were 6.4% and 33.3% (p = .007), with a median waiting period for elective cholecystectomy of 58 and 33 days (p = .390) in the cutting and removal groups, respectively. In the multivariate analysis, only endoscopic internalization by cutting was an independent factor affecting late AEs.ConclusionEndoscopic internalization by cutting ENGBD after the resolution of acute cholecystitis was considered effective in reducing the risk of late AEs during the waiting period for an elective cholecystectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic internalization by cutting versus removal of the endoscopic transpapillary naso‐gallbladder drainage tube in preoperative management of acute cholecystitis: A retrospective multicenter cohort study

Maruta

Iwashita

Yoshida

et al. 2023

J Hepato Biliary Pancreat

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“…Furthermore, the catheter can frequently dislocate from the gallbladder and necessitate reinsertion. 16 Patients with a non-independent lifestyle could be more vulnerable to sepsis secondary to recurrent cholecystitis. Hersey et al 2 reported on the safety and efficacy of CDS placement with 33 patients in 2015.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous cholecystoduodenal stent as a definite treatment for acute cholecystitis in elderly or comorbid patients: a bicentric retrospective study

Lee¹,

Kim²,

Shim³

et al. 2023

dir

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To investigate the safety and efficacy of percutaneous cholecystoduodenal stent (CDS) placement to prevent recurrence of acute cholecystitis in patients who were unfit for cholecystectomy. METHODSBetween April 2016 and January 2022, 46 patients [median age (range) = 81 (37-99) years; men = 15] with acute cholecystitis who were unfit for surgery underwent percutaneous cholecystostomy followed by a CDS placement in two institutions. Plastic stents of three different materials were used [polyethylene, polyurethane (PU), and polycarbonate (PCB)-based PU]. Clinical outcomes, including technical and clinical success rates and early (<30 days) and delayed adverse events, were retrospectively assessed by stent type. RESULTSCDS placement was technically successful in 39 patients. Clinical success, defined as cholecystostomy catheter removal, was achieved in 35 of 39 patients. Immediate complications, such as acute pancreatitis and peritonitis, occurred in two patients. Two patients experienced recurrent cholecystitis during a 113-day follow-up (range, 3-1,723). Three-stent groups had significantly different delayed complications on Fisher's exact test (P = 0.021). The Bonferroni post-hoc analysis showed the PCB-PU group tended to have fewer complications than the PU group (P = 0.060). CONCLUSIONCDS placement is applicable in treating acute cholecystitis patients who were initially unfit for surgery, but further investigation is needed. Although it was not statistically significant, a PCB-PU stent can be suitable for this use because it tends to have fewer delayed complications and is equipped with a drawstring and side holes.

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Acute cholecystitis: Which flow-chart for the most appropriate management?

Kurihara¹,

Binda²,

Cimino³

et al. 2023

Digestive and Liver Disease

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What makes acute cholecystitis recur after removing the percutaneous cholecystostomy tube?

Cited by 4 publications

References 21 publications

Endoscopic internalization by cutting versus removal of the endoscopic transpapillary naso‐gallbladder drainage tube in preoperative management of acute cholecystitis: A retrospective multicenter cohort study

Endoscopic internalization by cutting versus removal of the endoscopic transpapillary naso‐gallbladder drainage tube in preoperative management of acute cholecystitis: A retrospective multicenter cohort study

Percutaneous cholecystoduodenal stent as a definite treatment for acute cholecystitis in elderly or comorbid patients: a bicentric retrospective study

Acute cholecystitis: Which flow-chart for the most appropriate management?

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