Ethanol Chemical Gallbladder Ablation for Cholecystitis in Inoperable Elderly Patients

Area of Science:

• Minimally Invasive Procedures
• Gastroenterology
• Interventional Radiology

Background:

• Cholecystitis poses treatment challenges, particularly in elderly patients with high surgical risks.
• Cholecystectomy is standard but often not feasible, with cholecystostomy having high recurrence rates.
• A minimally invasive alternative is needed for acute cholecystitis in high-risk populations.

Purpose of the Study:

• To evaluate the efficacy and safety of chemical gallbladder ablation.
• To assess this minimally invasive option for acute cholecystitis in elderly and comorbid patients.

Main Methods:

• Retrospective study of patients undergoing chemical gallbladder ablation (2014-2024).
• Procedures included ultrasound-guided drainage, cholangiography, and ethanol ablation, with some receiving cystic duct embolization.
• Outcomes: complications, recurrence, gallbladder atrophy, and hospital stay.

Main Results:

• 20 patients underwent chemical ablation with no complications or ethanol intoxication; one recurrence.
• Gallbladder atrophy occurred in 5/6 patients with prior cystic duct embolization vs. 2/7 without.
• Median hospital stay was 20 days; median survival was 603 days.

Conclusions:

• Chemical gallbladder ablation with cystic duct embolization appears viable and safe for acute cholecystitis in elderly, comorbid patients.
• This minimally invasive approach offers a potential alternative to surgery.
• Further research is needed to confirm these findings.