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Transhepatic versus transperitoneal approach in percutaneous cholecystostomy: a meta-analysis
G Abdelhalim1, A MacCormick1, P Jenkins2
1Peninsula Radiology Academy, University Hospitals Plymouth NHS Trust, PL6 5WR, UK.
Clinical Radiology
|April 2, 2023
Summary
The transhepatic approach for percutaneous cholecystostomy has a higher bleeding risk compared to the transperitoneal method. However, both approaches are safe and effective for gallbladder drainage.
Area of Science:
- Medical procedures
- Gastroenterology
- Interventional radiology
Background:
- Percutaneous cholecystostomy is a minimally invasive procedure for gallbladder drainage.
- Choosing the optimal approach is crucial for patient safety and procedural success.
Approach:
- A systematic review and meta-analysis was conducted.
- Medline, EMBASE, and PubMed databases were searched for comparative studies.
- Statistical analysis used odds ratios to compare outcomes.
Key Points:
- Four studies involving 684 patients were analyzed.
- The transhepatic approach showed a significantly higher risk of bleeding (6.3%) versus the transperitoneal approach (1.6%).
- No significant differences were observed in pain, bile leak, or infection rates between the two methods.
Conclusions:
- Both transhepatic and transperitoneal approaches are safe for percutaneous cholecystostomy.
- Higher bleeding rates with the transhepatic route require consideration.
- Further research, including randomized trials, is needed to confirm findings due to study limitations.
