Postoperative bleeding after percutaneous transhepatic gallbladder drainage and aspiration in patients receiving...

Area of Science:

• Interventional Radiology
• Gastroenterology
• Cardiology

Background:

• Acute cholecystitis often requires intervention, with patients frequently on antithrombotic therapy.
• Percutaneous transhepatic gallbladder interventions are common procedures for acute cholecystitis.
• The impact of perioperative antithrombotic drug management on bleeding risk in these interventions is not fully understood.

Purpose of the Study:

• To investigate the association between antithrombotic therapy and bleeding risk in patients undergoing percutaneous transhepatic gallbladder interventions for acute cholecystitis.
• To identify specific antithrombotic drug regimens that pose a higher risk of postoperative bleeding.

Main Methods:

• Retrospective analysis of 194 patients with acute cholecystitis undergoing percutaneous transhepatic gallbladder interventions.
• Patients categorized into four groups based on antithrombotic therapy: none, discontinued, single drug continued, or multiple drugs continued.
• Multivariate logistic regression used to evaluate the risk of postoperative bleeding.

Main Results:

• Significant bleeding occurred in 10.3% of patients, with severe bleeding in 3.1%.
• Patients continuing multiple antithrombotic drugs perioperatively had a significantly higher rate of significant bleeding compared to those with no prior therapy (P = 0.006).
• Continuation of multiple antithrombotic drugs was identified as an independent risk factor for significant bleeding.

Conclusions:

• Perioperative continuation of multiple antithrombotic drugs is a significant risk factor for postoperative bleeding after percutaneous transhepatic gallbladder interventions.
• Careful consideration of antithrombotic drug management is crucial in patients undergoing these procedures.
• Further research may explore optimal antithrombotic strategies to balance thrombotic and bleeding risks.