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Percutaneous gallbladder aspiration for acute cholecystitis.
Supannee Rassameehiran1, Pakpoom Tantrachoti1, Kenneth Nugent1
1Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.
Proceedings (Baylor University. Medical Center)
|October 4, 2016
Summary
Percutaneous gallbladder aspiration (PGBA) is a viable alternative when early surgery for acute cholecystitis is not feasible. Repetitive PGBA with antibiotics and salvage procedures show high success rates.
Area of Science:
- Gastroenterology
- Interventional Radiology
Background:
- Early cholecystectomy for acute cholecystitis is not always clinically feasible.
- Percutaneous gallbladder aspiration (PGBA) presents an alternative, but its efficacy and safety require clarification.
Approach:
- A systematic review and meta-analysis of studies published between January 2000 and December 2015.
- Inclusion of seven eligible studies, with independent quality assessment by two reviewers.
Key Points:
- Single PGBA success rates ranged from 50% to 93%; repetitive PGBA (2-4 times) success rates were 76% to 96%.
- Complication rates were low (0% to 8%) and independent of needle gauge or aspiration frequency.
- Salvage percutaneous cholecystostomy (PC) was needed in 0% to 43% of cases; urgent surgery in 0% to 4%.
- Two studies incorporating antibiotic instillation reported clinical success rates of 95% and 96%.
Conclusions:
- Repetitive PGBA, especially with antibiotic instillation and subsequent salvage PC, offers a valuable alternative to immediate cholecystectomy for acute cholecystitis.
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