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Published on: January 31, 2025
464
Image-guided percutaneous cholecystostomy: challenging the norms
Nikolaos-Achilleas Arkoudis1, Lazaros Reppas2,3, Stavros Spiliopoulos3
1Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece. nick.arkoudis@gmail.com.
Abdominal Radiology (New York)
|January 31, 2024
Summary
Image-guided percutaneous cholecystostomy (IGPC) offers flexibility in patient care for acute cholecystitis. Recent findings show transperitoneal and transhepatic routes, along with trocar and Seldinger techniques, are equally safe and effective.
Area of Science:
- Interventional Radiology
- Gastroenterology
- Surgical Innovation
Background:
- Image-guided percutaneous cholecystostomy (IGPC) is a critical procedure for acute cholecystitis.
- Established beliefs regarding optimal IGPC techniques warrant re-evaluation.
- Operator concerns can impact procedural flexibility and patient outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of different routes and techniques for IGPC.
- To provide evidence-based insights to reassure clinicians performing IGPC.
- To encourage flexibility in IGPC procedural choices.
Main Methods:
- Review of current literature on IGPC.
- Comparative analysis of transperitoneal versus transhepatic routes.
- Assessment of trocar versus Seldinger techniques in IGPC.
Main Results:
- The transperitoneal route is as safe as the transhepatic route for IGPC.
- Both trocar and Seldinger techniques demonstrate equal safety and efficacy.
- Novel insights challenge previous assumptions about IGPC procedures.
Conclusions:
- IGPC offers procedural flexibility, with comparable safety across different routes and techniques.
- Clinicians can be reassured by the established safety and efficacy of various IGPC approaches.
- Further research is needed on approach variations, catheter sizes, and operator experience.
