Endoscopic Gallbladder Drainage Conversion versus Conservative Treatment Following Percutaneous Gallbladder Drainage in High-Risk Surgical Patients
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: There are no consensus guidelines for patients with acute cholecystitis undergoing percutaneous cholecystostomy who are unfit for interval cholecystectomy. The current study aimed to compare the clinical outcomes of endoscopic gallbladder drainage, i.e. conversion from percutaneous cholecystostomy (including endoscopic transpapillary gallbladder stenting and endoscopic ultrasound-guided gallbladder drainage), and conservative treatment after percutaneous cholecystostomy tube removal. Methods: This retrospective review included patients who underwent percutaneous cholecystostomy for acute cholecystitis between January 2017 and December 2020. Consecutive patients who underwent endoscopic gallbladder drainage or percutaneous cholecystostomy tube removal without interval cholecystectomy were included. Outcome measures included recurrent acute cholecystitis and unplanned readmission due to gallstone-related diseases. Results: During the study period, 238 patients were selected (63 underwent endoscopic gallbladder drainage conversion and 175 underwent conservative treatment). Patients who underwent endoscopic gallbladder drainage conversion had lower rates of recurrent acute cholecystitis (3 [4.76%] vs 31 [17.71%], p=0.012) and unplanned readmission due to gallstone-related diseases (6 [9.52%] vs 40 [22.86%], p=0.022) than those who underwent conservative treatment following percutaneous cholecystostomy tube removal. In the univariate and multivariate analyses, calculus cholecystitis (odds ratio, 13.75; 95% confidence interval, 1.83 to 102.83; p=0.011) and conversion of endoscopic gallbladder drainage (odds ratio, 0.23; 95% confidence interval, 0.06 to 0.78; p=0.019) were significant predictive factors for recurrent acute cholecystitis. Conclusions: Endoscopic gallbladder drainage conversion led to more favorable outcomes than conservative treatment after percutaneous cholecystostomy tube removal. Therefore, endoscopic gallbladder drainage conversion may be considered a promising treatment option for patients undergoing percutaneous cholecystostomy who are at a high surgical risk.
Abstract
Background/Aims: There are no consensus guidelines for patients with acute cholecystitis undergoing percutaneous cholecystostomy who are unfit for interval cholecystectomy. The current study aimed to compare the clinical outcomes of endoscopic gallbladder drainage, i.e. conversion from percutaneous cholecystostomy (including endoscopic transpapillary gallbladder stenting and endoscopic ultrasound-guided gallbladder drainage), and conservative treatment after percutaneous cholecystostomy tube removal. Methods: This retrospective review included patients who underwent percutaneous cholecystostomy for acute cholecystitis between January 2017 and December 2020. Consecutive patients who underwent endoscopic gallbladder drainage or percutaneous cholecystostomy tube removal without interval cholecystectomy were included. Outcome measures included recurrent acute cholecystitis and unplanned readmission due to gallstone-related diseases. Results: During the study period, 238 patients were selected (63 underwent endoscopic gallbladder drainage conversion and 175 underwent conservative treatment). Patients who underwent endoscopic gallbladder drainage conversion had lower rates of recurrent acute cholecystitis (3 [4.76%] vs 31 [17.71%], p=0.012) and unplanned readmission due to gallstone-related diseases (6 [9.52%] vs 40 [22.86%], p=0.022) than those who underwent conservative treatment following percutaneous cholecystostomy tube removal. In the univariate and multivariate analyses, calculus cholecystitis (odds ratio, 13.75; 95% confidence interval, 1.83 to 102.83; p=0.011) and conversion of endoscopic gallbladder drainage (odds ratio, 0.23; 95% confidence interval, 0.06 to 0.78; p=0.019) were significant predictive factors for recurrent acute cholecystitis. Conclusions: Endoscopic gallbladder drainage conversion led to more favorable outcomes than conservative treatment after percutaneous cholecystostomy tube removal. Therefore, endoscopic gallbladder drainage conversion may be considered a promising treatment option for patients undergoing percutaneous cholecystostomy who are at a high surgical risk.
참고문헌 (27)
- Kortram K, "Laparoscopic cholecystectomy for acute cholecystitis should be performed by a laparoscopic surgeon", Surg Endosc, 24, pp.2206~2209 (2010)
- Pavurala RB, "Percutaneous cholecystostomy-tube for highrisk patients with acute cholecystitis : current practice and implications for future research", Surg Endosc, 33, pp.3396~3403 (2019)
- Park SW, "Current status of endoscopic management of cholecystitis", Dig Endosc, 34, pp.439~450 (2022)
- Lee TH, "Outcomes of endoscopic transpapillary gallbladder stenting for symptomatic gallbladder diseases : a multicenter prospective follow-up study", Endoscopy, 43, pp.702~708 (2011)
- Storm AC, "Transpapillary gallbladder stent placement for long-term therapy of acute cholecystitis", Gastrointest Endosc, 94, pp.742~748 (2021)
- Takano Y, "Permanent endoscopic transpapillary gallbladder drainage using a novel spiral stent(IYO-stent)", DEN Open, 2, pp.e40~ (2021)
- Zerem E, "Is transpapillary gallbladder stenting better than percutaneous cholecystostomy for the treatment of symptomatic gallbladder disease in decompensated cirrhotic patients?", J Clin Gastroenterol, 49, pp.448~449 (2015)
- Krishnamoorthi R, "EUS-guided versus endoscopic transpapillary gallbladder drainage in high-risk surgical patients with acute cholecystitis : a systematic review and meta-analysis", Surg Endosc, 34, pp.1904~1913 (2020)
- Luk SW, "Endoscopic ultrasound-guided gallbladder drainage versus percutaneous cholecystostomy for high risk surgical patients with acute cholecystitis : a systematic review and meta-analysis", Endoscopy, 51, pp.722~732 (2019)
- Jain D, "Endoscopic ultrasound-guided gallbladder drainage using a lumenapposing metal stent for acute cholecystitis : a systematic review", Clin Endosc, 51, pp.450~462 (2018)
- Cho DH, "Feasibility and safety of endoscopic ultrasound-guided gallbladder drainage using a newly designed lumen-apposing metal stent", Surg Endosc, 33, pp.2135~2141 (2019)
- Chantarojanasiri T, "Feasibility of conversion of percutaneous cholecystostomy to internal transmural endoscopic ultrasound-guided gallbladder drainage", Saudi J Gastroenterol, 23, pp.318~322 (2017)
- Minaga K, "Clinical efficacy and safety of endoscopic ultrasound-guided gallbladder drainage replacement of percutaneous drainage : a multicenter retrospective study", Dig Endosc, 31, pp.180~187 (2019)
- Hayashi Y, "Conversion to EUS-guided internal gallbladder drainage from percutaneous cholecystostomy : a successful case using a novel plastic stent", Arab J Gastroenterol, 20, pp.117~120 (2019)
- Law R, "Conversion of percutaneous cholecystostomy to internal transmural gallbladder drainage using an endoscopic ultrasound-guided, lumen-apposing metal stent", Clin Gastroenterol Hepatol, 14, pp.476~480 (2016)
- Chon HK, "Efficacy and safety of conversion of percutaneous cholecystostomy to endoscopic transpapillary gallbladder stenting in high-risk surgical patients", Hepatobiliary Pancreat Dis Int, 20, pp.478~484 (2021)
- Yokoe M, "Tokyo Guidelines 2018 : diagnostic criteria and severity grading of acute cholecystitis(with videos)", J Hepatobiliary Pancreat Sci, 25, pp.41~54 (2018)
- Winbladh A, "Systematic review of cholecystostomy as a treatment option in acute cholecystitis", HPB(Oxford), 11, pp.183~193 (2009)
- McKay A, "Short-and longterm outcomes following percutaneous cholecystostomy for acute cholecystitis in high-risk patients", Surg Endosc, 26, pp.1343~1351 (2012)
- Ha JP, "Cholecystectomy or not after percutaneous cholecystostomy for acute calculous cholecystitis in high-risk patients", Hepatogastroenterology, 55, pp.1497~1502 (2008)
- Andrén-Sandberg A, "Complications and late outcome following percutaneous drainage of the gallbladder in acute calculous cholecystitis", Dig Surg, 18, pp.393~398 (2001)
- D’Agostino HB, "Imaging of the percutaneous cholecystostomy tract : observations and utility", Radiology, 181, pp.675~678 (1991)
- Hatjidakis AA, "Maturation of the tract after percutaneous cholecystostomy with regard to the access route", Cardiovasc Intervent Radiol, 21, pp.36~40 (1998)
- Wise JN, "Percutaneous cholecystostomy catheter removal and incidence of clinically significant bile leaks : a clinical approach to catheter management", AJR Am J Roentgenol, 184, pp.1647~1651 (2005)
- McCarty TR, "Endoscopic gallbladder drainage for symptomatic gallbladder disease : a cumulative systematic review meta-analysis", Surg Endosc, 35, pp.4964~4985 (2021)
- Teoh AY, "Use of a novel lumen apposing metallic stent for drainage of the bile duct and gallbladder : long term outcomes of a prospective international trial", Dig Endosc, 33, pp.1139~1145 (2021)
- Yoo HW, "A novel electrocautery-enhanced delivery system for one-step endoscopic ultrasoundguided drainage of the gallbladder and bile duct using a lumen-apposing metal stent : a feasibility study", Endoscopy, 53, pp.922~926 (2021)