Safety and adverse events of EUS-guided gallbladder drainage using lumen-apposing metal stents and percutaneous cholecystostomy tubes: a systematic review and meta-analysis
EUS-guided gallbladder drainage using lumen-apposing metal stents (EUS-GBD-LAMSs) and percutaneous cholecystostomy for gallbladder drainage (PTGBD) are the alternative treatment modalities in high-risk surgical patients with acute cholecystitis (AC). The aim of this study was to compare the safety o...
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| Published in: | Gastrointestinal endoscopy Vol. 99; no. 3; pp. 444 - 448.e1 |
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| Abstract | EUS-guided gallbladder drainage using lumen-apposing metal stents (EUS-GBD-LAMSs) and percutaneous cholecystostomy for gallbladder drainage (PTGBD) are the alternative treatment modalities in high-risk surgical patients with acute cholecystitis (AC). The aim of this study was to compare the safety of these procedures for AC in surgically suboptimal candidates.
Six studies compared the 2 groups’ early, delayed, and overall adverse events; they also compared length of hospital stay, re-interventions, and re-admissions rate. A random effect model calculated odds ratios (ORs) with a 95% confidence interval (CI).
The 2 groups had similar early adverse events; however, EUS-GBD-LAMS was associated with a lower rate of delayed (OR, .21; 95% CI, .07-.61; P ≤ .01) and overall (OR, .43; 95% CI, .30-.61; P ≤ .01) adverse events. Patients with EUS-GBD-LAMSs had a shorter hospital stay than PTGBD.
EUS-GBD-LAMS is a safer option than PTGBD and is associated with a shorter hospital stay in nonsurgical candidates with AC. |
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| AbstractList | EUS-guided gallbladder drainage using lumen-apposing metal stents (EUS-GBD-LAMSs) and percutaneous cholecystostomy for gallbladder drainage (PTGBD) are the alternative treatment modalities in high-risk surgical patients with acute cholecystitis (AC). The aim of this study was to compare the safety of these procedures for AC in surgically suboptimal candidates.BACKGROUND AND AIMSEUS-guided gallbladder drainage using lumen-apposing metal stents (EUS-GBD-LAMSs) and percutaneous cholecystostomy for gallbladder drainage (PTGBD) are the alternative treatment modalities in high-risk surgical patients with acute cholecystitis (AC). The aim of this study was to compare the safety of these procedures for AC in surgically suboptimal candidates.Six studies compared the 2 groups' early, delayed, and overall adverse events; they also compared length of hospital stay, re-interventions, and re-admissions rate. A random effect model calculated odds ratios (ORs) with a 95% confidence interval (CI).METHODSSix studies compared the 2 groups' early, delayed, and overall adverse events; they also compared length of hospital stay, re-interventions, and re-admissions rate. A random effect model calculated odds ratios (ORs) with a 95% confidence interval (CI).The 2 groups had similar early adverse events; however, EUS-GBD-LAMS was associated with a lower rate of delayed (OR, .21; 95% CI, .07-.61; P ≤ .01) and overall (OR, .43; 95% CI, .30-.61; P ≤ .01) adverse events. Patients with EUS-GBD-LAMSs had a shorter hospital stay than PTGBD.RESULTSThe 2 groups had similar early adverse events; however, EUS-GBD-LAMS was associated with a lower rate of delayed (OR, .21; 95% CI, .07-.61; P ≤ .01) and overall (OR, .43; 95% CI, .30-.61; P ≤ .01) adverse events. Patients with EUS-GBD-LAMSs had a shorter hospital stay than PTGBD.EUS-GBD-LAMS is a safer option than PTGBD and is associated with a shorter hospital stay in nonsurgical candidates with AC.CONCLUSIONSEUS-GBD-LAMS is a safer option than PTGBD and is associated with a shorter hospital stay in nonsurgical candidates with AC. EUS-guided gallbladder drainage using lumen-apposing metal stents (EUS-GBD-LAMSs) and percutaneous cholecystostomy for gallbladder drainage (PTGBD) are the alternative treatment modalities in high-risk surgical patients with acute cholecystitis (AC). The aim of this study was to compare the safety of these procedures for AC in surgically suboptimal candidates. Six studies compared the 2 groups’ early, delayed, and overall adverse events; they also compared length of hospital stay, re-interventions, and re-admissions rate. A random effect model calculated odds ratios (ORs) with a 95% confidence interval (CI). The 2 groups had similar early adverse events; however, EUS-GBD-LAMS was associated with a lower rate of delayed (OR, .21; 95% CI, .07-.61; P ≤ .01) and overall (OR, .43; 95% CI, .30-.61; P ≤ .01) adverse events. Patients with EUS-GBD-LAMSs had a shorter hospital stay than PTGBD. EUS-GBD-LAMS is a safer option than PTGBD and is associated with a shorter hospital stay in nonsurgical candidates with AC. |
| Author | Al Shabeeb, Reem Hensien, Jack Ahmad, Oneeb Siddiqui, Ali A. Sakhawat, Usama Haseeb, Muhammad Hayat, Umar Adler, Douglas G. Perez, Paola Dwivedi, Aanini |
| Author_xml | – sequence: 1 givenname: Umar surname: Hayat fullname: Hayat, Umar organization: Department of Internal Medicine, Division of Gastroenterology, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, USA – sequence: 2 givenname: Reem surname: Al Shabeeb fullname: Al Shabeeb, Reem organization: Department of Internal Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia, USA – sequence: 3 givenname: Paola surname: Perez fullname: Perez, Paola organization: University of Virginia School of Medicine, Charlottesville, Virginia, USA – sequence: 4 givenname: Jack surname: Hensien fullname: Hensien, Jack organization: University of Virginia School of Medicine, Charlottesville, Virginia, USA – sequence: 5 givenname: Aanini surname: Dwivedi fullname: Dwivedi, Aanini organization: University of Virginia School of Medicine, Charlottesville, Virginia, USA – sequence: 6 givenname: Usama surname: Sakhawat fullname: Sakhawat, Usama organization: Department of Internal Medicine, UHS Wilson Medical Center, Binghamton, New York, USA – sequence: 7 givenname: Oneeb surname: Ahmad fullname: Ahmad, Oneeb organization: Department of Internal Medicine, UHS Wilson Medical Center, Binghamton, New York, USA – sequence: 8 givenname: Muhammad surname: Haseeb fullname: Haseeb, Muhammad organization: Hospitalist Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA – sequence: 9 givenname: Ali A. surname: Siddiqui fullname: Siddiqui, Ali A. organization: Division of Gastroenterology, Inova Fairfax Medical Campus, Falls Church, Virginia, USA – sequence: 10 givenname: Douglas G. surname: Adler fullname: Adler, Douglas G. email: dougraham2001@gmail.com organization: Center for Advanced Therapeutic Endoscopy, Porter Adventist Hospital, Denver, Colorado, USA |
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| Cites_doi | 10.1016/j.giec.2017.11.006 10.1136/gutjnl-2019-319996 10.1016/j.cgh.2016.12.021 10.2214/ajr.176.4.1761025 10.1016/j.gie.2020.03.1128 10.4240/wjgs.v9.i5.118 10.1016/j.gie.2021.03.508 10.1007/s00464-022-09712-x 10.1007/s00464-018-6406-7 |
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| Keywords | AC OR LAMSs CI GRADE PTGBD EUS-GBD |
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