May 5, 2010

Endoscopic gallbladder drainage for management of acute cholecystitis

Gastrointestinal Endoscopy
Takao ItoiTodd H Baron

Abstract

Nonoperative gallbladder drainage methods for acute cholecystitis include percutaneous transhepatic gallbladder drainage and percutaneous transhepatic gallbladder aspiration, endoscopic nasogallbladder drainage and gallbladder stenting via a transpapillary endoscopic approach, and EUS-guided nasogallbladder drainage and gallbladder stenting via a transmural endoscopic approach. A systematic review was performed to evaluate the current potential role of each gallbladder drainage technique for acute cholecystitis. MEDLINE, EMBASE, and manual searches were performed to identify pertinent English-language articles. The technical success rate, clinical success rate, and the frequency of adverse events in percutaneous transhepatic gallbladder aspiration (n = 122) and percutaneous transhepatic gallbladder drainage (n = 246) were 93% and 98%, 83% and 90%, and 0.8% and 3.7%, respectively. In contrast, the technical success rate, clinical success rate, and the frequency of adverse events in endoscopic nasogallbladder drainage (n = 194) and endoscopic gallbladder stenting (n = 127) were 81% and 96%, 75% and 88%, and 3.6% (n = 7) and 6.3% (n = 8), respectively. Although there have been 2 small case series of successful EUS-guided transmura...Continue Reading

Mentioned in this Paper

Endoscopy (Procedure)
Pseudocyst
Diagnostic Radiology Modality
Meta-Analysis (Publications)
Intestinal Perforation
Entire Cystic Duct
Extravasation
Pancreatitis
Gallbladder (Mmhcc)
Recurrent Malignant Neoplasm

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