Efficacy of endoscopic gallbladder drainage in patients with acute cholecystitis
Abstract Background Early cholecystectomy is recommended for patients with acute cholecystitis. However, emergency surgery may not be indicated due to complications and disease severity. Patients requiring drainage are usually treated with percutaneous transhepatic gallbladder drainage (PTGBD), wher...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-022-01676-y |
| _version_ | 1811248928901824512 |
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| author | Anri Kaneta Hirotaka Sasada Takuma Matsumoto Tsuyoshi Sakai Shuichi Sato Takashi Hara |
| author_facet | Anri Kaneta Hirotaka Sasada Takuma Matsumoto Tsuyoshi Sakai Shuichi Sato Takashi Hara |
| author_sort | Anri Kaneta |
| collection | DOAJ |
| description | Abstract Background Early cholecystectomy is recommended for patients with acute cholecystitis. However, emergency surgery may not be indicated due to complications and disease severity. Patients requiring drainage are usually treated with percutaneous transhepatic gallbladder drainage (PTGBD), whereas patients with biliary duct stones undergo endoscopic stones removal followed by endoscopic gallbladder drainage (EGBD). Herein, we investigated the efficacy of EGBD in patients with acute cholecystitis. Methods Overall, 101 patients receiving laparoscopic cholecystectomy between September 2019 and September 2020 in our department were retrospectively analyzed. Results The patients (n = 101) were divided into three groups: control group that did not undergo drainage (n = 68), a group that underwent EGBD (n = 7), and a group that underwent PTGBD (n = 26). Median surgery time was 107, 166, and 143 min, respectively. Control group had a significantly shorter surgery time, whereas it did not significantly differ between EGBD and PTGBD groups. The median amount of bleeding was 5 g, 7 g, and 7.5 g, respectively, and control group had significantly less bleeding than the drainage group. We further divided patients into the following subgroups: patients requiring a 5 mm clip to ligate the cystic duct, patients requiring a 10 mm clip due to the thickness of the cystic duct, patients requiring an automatic suturing device, and patients undergoing subtotal cholecystectomy due to impossible cystic duct ligation. There was no significant difference between EGBD and PTGBD regarding the clip used or the need for an automatic suturing device and subtotal cholecystectomy. Conclusions There was no significant difference between EGBD and PTGBD groups regarding surgery time or bleeding amount when surgery was performed after gallbladder drainage for acute cholecystitis. Therefore, EGBD was considered a useful preoperative drainage method requiring no drainage bag. |
| first_indexed | 2024-04-12T15:36:28Z |
| format | Article |
| id | doaj.art-33c43b547fd142debb6045a13ae25bed |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-12T15:36:28Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-33c43b547fd142debb6045a13ae25bed2022-12-22T03:26:56ZengBMCBMC Surgery1471-24822022-06-012211610.1186/s12893-022-01676-yEfficacy of endoscopic gallbladder drainage in patients with acute cholecystitisAnri Kaneta0Hirotaka Sasada1Takuma Matsumoto2Tsuyoshi Sakai3Shuichi Sato4Takashi Hara5Department of Surgery, Kensei HospitalDepartment of Surgery, Kensei HospitalDepartment of Surgery, Kensei HospitalDepartment of Surgery, Kensei HospitalDepartment of Surgery, Kensei HospitalDepartment of Surgery, Kensei HospitalAbstract Background Early cholecystectomy is recommended for patients with acute cholecystitis. However, emergency surgery may not be indicated due to complications and disease severity. Patients requiring drainage are usually treated with percutaneous transhepatic gallbladder drainage (PTGBD), whereas patients with biliary duct stones undergo endoscopic stones removal followed by endoscopic gallbladder drainage (EGBD). Herein, we investigated the efficacy of EGBD in patients with acute cholecystitis. Methods Overall, 101 patients receiving laparoscopic cholecystectomy between September 2019 and September 2020 in our department were retrospectively analyzed. Results The patients (n = 101) were divided into three groups: control group that did not undergo drainage (n = 68), a group that underwent EGBD (n = 7), and a group that underwent PTGBD (n = 26). Median surgery time was 107, 166, and 143 min, respectively. Control group had a significantly shorter surgery time, whereas it did not significantly differ between EGBD and PTGBD groups. The median amount of bleeding was 5 g, 7 g, and 7.5 g, respectively, and control group had significantly less bleeding than the drainage group. We further divided patients into the following subgroups: patients requiring a 5 mm clip to ligate the cystic duct, patients requiring a 10 mm clip due to the thickness of the cystic duct, patients requiring an automatic suturing device, and patients undergoing subtotal cholecystectomy due to impossible cystic duct ligation. There was no significant difference between EGBD and PTGBD regarding the clip used or the need for an automatic suturing device and subtotal cholecystectomy. Conclusions There was no significant difference between EGBD and PTGBD groups regarding surgery time or bleeding amount when surgery was performed after gallbladder drainage for acute cholecystitis. Therefore, EGBD was considered a useful preoperative drainage method requiring no drainage bag.https://doi.org/10.1186/s12893-022-01676-yAcute cholecystitisGallbladder drainageEndoscopic trans-papillary gallbladder drainagePercutaneous transhepatic gallbladder drainageLaparoscopic cholecystectomySubtotal cholecystectomy |
| spellingShingle | Anri Kaneta Hirotaka Sasada Takuma Matsumoto Tsuyoshi Sakai Shuichi Sato Takashi Hara Efficacy of endoscopic gallbladder drainage in patients with acute cholecystitis BMC Surgery Acute cholecystitis Gallbladder drainage Endoscopic trans-papillary gallbladder drainage Percutaneous transhepatic gallbladder drainage Laparoscopic cholecystectomy Subtotal cholecystectomy |
| title | Efficacy of endoscopic gallbladder drainage in patients with acute cholecystitis |
| title_full | Efficacy of endoscopic gallbladder drainage in patients with acute cholecystitis |
| title_fullStr | Efficacy of endoscopic gallbladder drainage in patients with acute cholecystitis |
| title_full_unstemmed | Efficacy of endoscopic gallbladder drainage in patients with acute cholecystitis |
| title_short | Efficacy of endoscopic gallbladder drainage in patients with acute cholecystitis |
| title_sort | efficacy of endoscopic gallbladder drainage in patients with acute cholecystitis |
| topic | Acute cholecystitis Gallbladder drainage Endoscopic trans-papillary gallbladder drainage Percutaneous transhepatic gallbladder drainage Laparoscopic cholecystectomy Subtotal cholecystectomy |
| url | https://doi.org/10.1186/s12893-022-01676-y |
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