The Efficacy and Safety of EUS-Guided Gallbladder Drainage as a Bridge to Surgery for Patients with Acute Cholecystitis

• Published in: Journal of clinical medicine Vol. 12; no. 8; p. 2778
• Main Authors: Ishii, Ken, Fujita, Yuji, Suzuki, Eisuke, Koyama, Yuji, Tsujino, Seitaro, Nagao, Atsuki, Hosono, Kunihiro, Teratani, Takuma, Kubota, Kensuke, Nakajima, Atsushi
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 08-04-2023; MDPI
• Subjects: Bile ducts; Care and treatment; Catheters; Cholecystectomy; Cholecystitis; Clinical medicine; Diagnosis; Disease; Drainage, Surgical; Endoscopy; Gallbladder; Gallbladder diseases; Gallstones; Laboratories; Laparoscopy; Patient outcomes; Patients; Peritonitis; Statistical analysis; Success; Surgeons; Surgery; Ultrasonic imaging; Japan; acute cholecystitis; bridge to surgery; EUS drainage
• DOI: 10.3390/jcm12082778
• EISSN: 2077-0383

This study aimed to compare the efficacy and safety of endoscopic ultrasound-guided gallbladder drainage and percutaneous transhepatic gallbladder drainage as a bridge to surgery in patients with acute cholecystitis unfit for urgent cholecystectomy.
This retrospective study included 46 patients who underwent cholecystectomy following endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) or percutaneous transhepatic gallbladder drainage (PTGBD) for acute cholecystitis in NTT Tokyo Medical Center. We surveyed 35 patients as the EUS-GBD group and 11 patients as the PTGBD group, and compared the rate of technical success of the cholecystectomy and periprocedural adverse events. A 7-F, 10-cm double pigtail plastic stent was used for ultrasound-guided gallbladder drainage.
The rate of technical success of cholecystectomy was 100% in both groups. Regarding postsurgical adverse events, no significant difference was noted between the two groups (EUS-GBD group, 11.4%, vs. PTGBD group, 9.0%;
0.472).
EUS-GBD as a BTS seems to be an alternative for patients with AC because it can ensure lower adverse events. On the other hand, there are two major limitations in this study--the sample size is small and there is a risk of selection bias.