TG13 indications and techniques for gallbladder drainage in acute cholecystitis (with videos)

Area of Science:

• Gastroenterology
• Interventional Radiology
• Surgical Oncology

Background:

• Acute cholecystitis management often involves gallbladder drainage.
• Percutaneous transhepatic gallbladder drainage (PTGBD) is a widely adopted method.
• Surgical options like cholecystectomy may pose high risks for certain patients.

Purpose of the Study:

• To review the indications and techniques for gallbladder drainage in acute cholecystitis.
• To compare PTGBD with alternative gallbladder drainage methods.
• To highlight the current status and future research needs for various drainage approaches.

Main Methods:

• Review of retrospective studies and case-series on gallbladder drainage techniques.
• Comparison of success rates and complication profiles of different methods.
• Discussion of emerging techniques like endoscopic ultrasonography-guided drainage.

Main Results:

• PTGBD is the most common gallbladder drainage method, considered safe for high-risk patients.
• Percutaneous transhepatic gallbladder aspiration is simpler but less studied.
• Endoscopic approaches have technical challenges and lower success rates than PTGBD.
• Endoscopic ultrasonography-guided drainage is emerging but not yet established.

Conclusions:

• PTGBD remains a primary choice for gallbladder drainage in acute cholecystitis.
• Alternative methods require further prospective evaluation for safety and efficacy.
• Established techniques should be performed in high-volume centers by experienced specialists.