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Percutaneous and endoscopic gallbladder drainage for acute cholecystitis: international multicenter comparative study
Takao Itoi1, Tadahiro Takada2, Tsann-Long Hwang3
1Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Tokyo, Japan.
Journal of Hepato-Biliary-Pancreatic Sciences
|April 4, 2017
Summary
Percutaneous transhepatic intervention (PTGBI) and endoscopic transpapillary gallbladder drainage (EGBD) show similar clinical efficacy for acute cholecystitis. PTGBI demonstrated comparable complication rates to EGBD, supporting its use.
Area of Science:
- Gastroenterology
- Interventional Radiology
- Surgical Oncology
Background:
- Tokyo Guideline 2013 (TG13) recommends three drainage techniques for acute cholecystitis.
- Percutaneous transhepatic intervention (PTGBI), encompassing PTGBD and PTGBA, and endoscopic transpapillary gallbladder drainage (EGBD) are key treatments.
Purpose of the Study:
- To compare the clinical efficacy and adverse events of PTGBI versus EGBD in treating acute cholecystitis.
- To evaluate the effectiveness of different PTGBI techniques (PTGBD, PTGBA) against EGBD.
Main Methods:
- A propensity score-matched cohort study analyzed 1,764 patients undergoing PTGBI or EGBD.
- 330 matched pairs were extracted to minimize treatment selection bias.
Main Results:
- Clinical success rates within 3 and 7 days were similar between PTGBI (62.5%, 87.6%) and EGBD (69.8%, 89.2%).
- Complication rates were comparable (PTGBI 4.8% vs. EGBD 8.2%). PTGBD (5.6%) was longer than PTGBA (1.6%) and EGBD (8.2%).
- PTGBD required significantly more days (3.0) compared to PTGBA (1.5) and EGBD (2.0).
Conclusions:
- PTGBI offers comparable clinical efficacy to EGBD for acute cholecystitis.
- No significant difference in complication rates was observed between PTGBI and EGBD.
- PTGBI is a viable alternative to EGBD for acute cholecystitis management.