Percutaneous Transhepatic Gallbladder Intervention as a Bridge to Cholecystectomy: Aspiration or Drainage?
Background Percutaneous transhepatic gallbladder aspiration (PTGBA) and percutaneous transhepatic gallbladder drainage (PTGBD) are often the first-line treatments for acute cholecystitis, instead of surgical cholecystectomy. This retrospective study aimed to compare the treatment outcomes of PTGBA a...
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| Veröffentlicht in: | World journal of surgery 2023-07, Vol.47 (7), p.1721-1728 |
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| creator | Nakamura, Yuki Kuwahara, Mai Ito, Kyoji Inagaki, Fuyuki Mihara, Fuminori Takemura, Nobuyuki Kokudo, Norihiro |
| description | Background
Percutaneous transhepatic gallbladder aspiration (PTGBA) and percutaneous transhepatic gallbladder drainage (PTGBD) are often the first-line treatments for acute cholecystitis, instead of surgical cholecystectomy. This retrospective study aimed to compare the treatment outcomes of PTGBA and PTGBD and evaluate the risks of treatment failure among patients undergoing PTGBA before surgical cholecystectomy.
Methods
We retrospectively reviewed 99 patients who underwent PTGBA or PTGBD as the first-line treatment before surgical cholecystectomy, between January 2014 and December 2019. Patient characteristics, computed tomography (CT) findings, and post-treatment outcomes were compared between the PTGBA and PTGBD groups. Additionally, risk factors, including CT findings for PTGBA failure, were assessed using multivariate univariate analysis with a backward selection model.
Results
Acute cholecystitis was not controlled in 21 of 47 (44.7%) patients in the PTGBA group and one of 52 patients (1.9%) in the PTGBD group (
P
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| doi_str_mv | 10.1007/s00268-023-06987-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2793990597</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2793990597</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4260-b5cda3e770480a07e5e225c9989526e950114606aed9e0ca6af1ef995f7f820c3</originalsourceid><addsrcrecordid>eNqNkU1v1DAURS0EokPhD7BAltiwCTzbiR13g9qBfqBKIFHE0nrjvEwzysSDnYDm32OalkosKlb24pyra1_GXgp4KwDMuwQgdV2AVAVoW5tCP2ILUSpZSCXVY7YApct8F-qAPUtpAyCMBv2UHSgD2QVYsM0Xin4acaAwJX4VcUjXtMOx8_wM-37VY9NQ5BfDSPEnDWMXBo6JIz-JXbMmPga-vA49-X0ayY9huz_ix2nXRbxBQ-QfInYDrun9c_akxT7Ri9vzkH07_Xi1PC8uP59dLI8vC19KDcWq8g0qMgbKGhAMVSRl5a2tbSU12QqEKPMzkBpL4FFjK6i1tmpNW0vw6pC9mXN3MfyYKI1u2yVPfT8_0kljlbVQWZPR1_-gmzDFIbdzMmfVUkBVZ0rOlI8hpUit28Vui3HvBLg_S7h5CZeXcDdLOJ2lV7fR02pLzV_l7uszcDQDv7qe9v8R6b5_-npyCiJ3z7Ka5ZS9YU3xvvgDnX4DSiukyA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2820821058</pqid></control><display><type>article</type><title>Percutaneous Transhepatic Gallbladder Intervention as a Bridge to Cholecystectomy: Aspiration or Drainage?</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals - AutoHoldings</source><creator>Nakamura, Yuki ; Kuwahara, Mai ; Ito, Kyoji ; Inagaki, Fuyuki ; Mihara, Fuminori ; Takemura, Nobuyuki ; Kokudo, Norihiro</creator><creatorcontrib>Nakamura, Yuki ; Kuwahara, Mai ; Ito, Kyoji ; Inagaki, Fuyuki ; Mihara, Fuminori ; Takemura, Nobuyuki ; Kokudo, Norihiro</creatorcontrib><description>Background
Percutaneous transhepatic gallbladder aspiration (PTGBA) and percutaneous transhepatic gallbladder drainage (PTGBD) are often the first-line treatments for acute cholecystitis, instead of surgical cholecystectomy. This retrospective study aimed to compare the treatment outcomes of PTGBA and PTGBD and evaluate the risks of treatment failure among patients undergoing PTGBA before surgical cholecystectomy.
Methods
We retrospectively reviewed 99 patients who underwent PTGBA or PTGBD as the first-line treatment before surgical cholecystectomy, between January 2014 and December 2019. Patient characteristics, computed tomography (CT) findings, and post-treatment outcomes were compared between the PTGBA and PTGBD groups. Additionally, risk factors, including CT findings for PTGBA failure, were assessed using multivariate univariate analysis with a backward selection model.
Results
Acute cholecystitis was not controlled in 21 of 47 (44.7%) patients in the PTGBA group and one of 52 patients (1.9%) in the PTGBD group (
P
< .001). Subsequent multiple logistic regression analysis identified the contrast effect of the gallbladder bed in the arterial phase of contrast-enhanced CT (odds ratio [OR] 9.17, 95% confidence interval [CI] 2.08–40.4,
P
= 0.003) and onset within 3 days (odds ratio [OR] 6.29, 95% confidence interval [CI] 1.37–29.0,
P
= 0.018) as independent risk factors for PTGBA failure.
Conclusions
PTGBA is more prone to failure than PTGBD; however, it is a simpler gallbladder drainage treatment method without the need for X-ray fluoroscopy and catheter management after the procedure. Evaluating the risk of PTGBA failure using CT findings and onset date would help us choose a drainage approach more effectively.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-023-06987-6</identifier><identifier>PMID: 37000200</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Cardiac Surgery ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute - surgery ; Clinical outcomes ; Computed tomography ; Confidence intervals ; Drainage - methods ; Failure analysis ; Fluoroscopy ; Gallbladder ; Gallbladder - diagnostic imaging ; Gallbladder - surgery ; Gallbladder diseases ; General Surgery ; Humans ; Medical instruments ; Medicine ; Medicine & Public Health ; Original Scientific Report ; Regression analysis ; Retrospective Studies ; Risk factors ; Statistical analysis ; Surgery ; Surgical drains ; Thoracic Surgery ; Treatment Outcome ; Vascular Surgery ; Wound drainage</subject><ispartof>World journal of surgery, 2023-07, Vol.47 (7), p.1721-1728</ispartof><rights>The Author(s) under exclusive licence to Société Internationale de Chirurgie 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4260-b5cda3e770480a07e5e225c9989526e950114606aed9e0ca6af1ef995f7f820c3</citedby><cites>FETCH-LOGICAL-c4260-b5cda3e770480a07e5e225c9989526e950114606aed9e0ca6af1ef995f7f820c3</cites><orcidid>0000-0002-4098-330X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-023-06987-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-023-06987-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,41464,42533,45550,45551,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37000200$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakamura, Yuki</creatorcontrib><creatorcontrib>Kuwahara, Mai</creatorcontrib><creatorcontrib>Ito, Kyoji</creatorcontrib><creatorcontrib>Inagaki, Fuyuki</creatorcontrib><creatorcontrib>Mihara, Fuminori</creatorcontrib><creatorcontrib>Takemura, Nobuyuki</creatorcontrib><creatorcontrib>Kokudo, Norihiro</creatorcontrib><title>Percutaneous Transhepatic Gallbladder Intervention as a Bridge to Cholecystectomy: Aspiration or Drainage?</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
Percutaneous transhepatic gallbladder aspiration (PTGBA) and percutaneous transhepatic gallbladder drainage (PTGBD) are often the first-line treatments for acute cholecystitis, instead of surgical cholecystectomy. This retrospective study aimed to compare the treatment outcomes of PTGBA and PTGBD and evaluate the risks of treatment failure among patients undergoing PTGBA before surgical cholecystectomy.
Methods
We retrospectively reviewed 99 patients who underwent PTGBA or PTGBD as the first-line treatment before surgical cholecystectomy, between January 2014 and December 2019. Patient characteristics, computed tomography (CT) findings, and post-treatment outcomes were compared between the PTGBA and PTGBD groups. Additionally, risk factors, including CT findings for PTGBA failure, were assessed using multivariate univariate analysis with a backward selection model.
Results
Acute cholecystitis was not controlled in 21 of 47 (44.7%) patients in the PTGBA group and one of 52 patients (1.9%) in the PTGBD group (
P
< .001). Subsequent multiple logistic regression analysis identified the contrast effect of the gallbladder bed in the arterial phase of contrast-enhanced CT (odds ratio [OR] 9.17, 95% confidence interval [CI] 2.08–40.4,
P
= 0.003) and onset within 3 days (odds ratio [OR] 6.29, 95% confidence interval [CI] 1.37–29.0,
P
= 0.018) as independent risk factors for PTGBA failure.
Conclusions
PTGBA is more prone to failure than PTGBD; however, it is a simpler gallbladder drainage treatment method without the need for X-ray fluoroscopy and catheter management after the procedure. Evaluating the risk of PTGBA failure using CT findings and onset date would help us choose a drainage approach more effectively.</description><subject>Abdominal Surgery</subject><subject>Cardiac Surgery</subject><subject>Cholecystectomy</subject><subject>Cholecystectomy, Laparoscopic</subject><subject>Cholecystitis</subject><subject>Cholecystitis, Acute - surgery</subject><subject>Clinical outcomes</subject><subject>Computed tomography</subject><subject>Confidence intervals</subject><subject>Drainage - methods</subject><subject>Failure analysis</subject><subject>Fluoroscopy</subject><subject>Gallbladder</subject><subject>Gallbladder - diagnostic imaging</subject><subject>Gallbladder - surgery</subject><subject>Gallbladder diseases</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Medical instruments</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Scientific Report</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Surgical drains</subject><subject>Thoracic Surgery</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><subject>Wound drainage</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkU1v1DAURS0EokPhD7BAltiwCTzbiR13g9qBfqBKIFHE0nrjvEwzysSDnYDm32OalkosKlb24pyra1_GXgp4KwDMuwQgdV2AVAVoW5tCP2ILUSpZSCXVY7YApct8F-qAPUtpAyCMBv2UHSgD2QVYsM0Xin4acaAwJX4VcUjXtMOx8_wM-37VY9NQ5BfDSPEnDWMXBo6JIz-JXbMmPga-vA49-X0ayY9huz_ix2nXRbxBQ-QfInYDrun9c_akxT7Ri9vzkH07_Xi1PC8uP59dLI8vC19KDcWq8g0qMgbKGhAMVSRl5a2tbSU12QqEKPMzkBpL4FFjK6i1tmpNW0vw6pC9mXN3MfyYKI1u2yVPfT8_0kljlbVQWZPR1_-gmzDFIbdzMmfVUkBVZ0rOlI8hpUit28Vui3HvBLg_S7h5CZeXcDdLOJ2lV7fR02pLzV_l7uszcDQDv7qe9v8R6b5_-npyCiJ3z7Ka5ZS9YU3xvvgDnX4DSiukyA</recordid><startdate>202307</startdate><enddate>202307</enddate><creator>Nakamura, Yuki</creator><creator>Kuwahara, Mai</creator><creator>Ito, Kyoji</creator><creator>Inagaki, Fuyuki</creator><creator>Mihara, Fuminori</creator><creator>Takemura, Nobuyuki</creator><creator>Kokudo, Norihiro</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4098-330X</orcidid></search><sort><creationdate>202307</creationdate><title>Percutaneous Transhepatic Gallbladder Intervention as a Bridge to Cholecystectomy: Aspiration or Drainage?</title><author>Nakamura, Yuki ; Kuwahara, Mai ; Ito, Kyoji ; Inagaki, Fuyuki ; Mihara, Fuminori ; Takemura, Nobuyuki ; Kokudo, Norihiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4260-b5cda3e770480a07e5e225c9989526e950114606aed9e0ca6af1ef995f7f820c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Abdominal Surgery</topic><topic>Cardiac Surgery</topic><topic>Cholecystectomy</topic><topic>Cholecystectomy, Laparoscopic</topic><topic>Cholecystitis</topic><topic>Cholecystitis, Acute - surgery</topic><topic>Clinical outcomes</topic><topic>Computed tomography</topic><topic>Confidence intervals</topic><topic>Drainage - methods</topic><topic>Failure analysis</topic><topic>Fluoroscopy</topic><topic>Gallbladder</topic><topic>Gallbladder - diagnostic imaging</topic><topic>Gallbladder - surgery</topic><topic>Gallbladder diseases</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Medical instruments</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Scientific Report</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Surgical drains</topic><topic>Thoracic Surgery</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><topic>Wound drainage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakamura, Yuki</creatorcontrib><creatorcontrib>Kuwahara, Mai</creatorcontrib><creatorcontrib>Ito, Kyoji</creatorcontrib><creatorcontrib>Inagaki, Fuyuki</creatorcontrib><creatorcontrib>Mihara, Fuminori</creatorcontrib><creatorcontrib>Takemura, Nobuyuki</creatorcontrib><creatorcontrib>Kokudo, Norihiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakamura, Yuki</au><au>Kuwahara, Mai</au><au>Ito, Kyoji</au><au>Inagaki, Fuyuki</au><au>Mihara, Fuminori</au><au>Takemura, Nobuyuki</au><au>Kokudo, Norihiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Percutaneous Transhepatic Gallbladder Intervention as a Bridge to Cholecystectomy: Aspiration or Drainage?</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2023-07</date><risdate>2023</risdate><volume>47</volume><issue>7</issue><spage>1721</spage><epage>1728</epage><pages>1721-1728</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
Percutaneous transhepatic gallbladder aspiration (PTGBA) and percutaneous transhepatic gallbladder drainage (PTGBD) are often the first-line treatments for acute cholecystitis, instead of surgical cholecystectomy. This retrospective study aimed to compare the treatment outcomes of PTGBA and PTGBD and evaluate the risks of treatment failure among patients undergoing PTGBA before surgical cholecystectomy.
Methods
We retrospectively reviewed 99 patients who underwent PTGBA or PTGBD as the first-line treatment before surgical cholecystectomy, between January 2014 and December 2019. Patient characteristics, computed tomography (CT) findings, and post-treatment outcomes were compared between the PTGBA and PTGBD groups. Additionally, risk factors, including CT findings for PTGBA failure, were assessed using multivariate univariate analysis with a backward selection model.
Results
Acute cholecystitis was not controlled in 21 of 47 (44.7%) patients in the PTGBA group and one of 52 patients (1.9%) in the PTGBD group (
P
< .001). Subsequent multiple logistic regression analysis identified the contrast effect of the gallbladder bed in the arterial phase of contrast-enhanced CT (odds ratio [OR] 9.17, 95% confidence interval [CI] 2.08–40.4,
P
= 0.003) and onset within 3 days (odds ratio [OR] 6.29, 95% confidence interval [CI] 1.37–29.0,
P
= 0.018) as independent risk factors for PTGBA failure.
Conclusions
PTGBA is more prone to failure than PTGBD; however, it is a simpler gallbladder drainage treatment method without the need for X-ray fluoroscopy and catheter management after the procedure. Evaluating the risk of PTGBA failure using CT findings and onset date would help us choose a drainage approach more effectively.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37000200</pmid><doi>10.1007/s00268-023-06987-6</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-4098-330X</orcidid></addata></record> |
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| subjects | Abdominal Surgery Cardiac Surgery Cholecystectomy Cholecystectomy, Laparoscopic Cholecystitis Cholecystitis, Acute - surgery Clinical outcomes Computed tomography Confidence intervals Drainage - methods Failure analysis Fluoroscopy Gallbladder Gallbladder - diagnostic imaging Gallbladder - surgery Gallbladder diseases General Surgery Humans Medical instruments Medicine Medicine & Public Health Original Scientific Report Regression analysis Retrospective Studies Risk factors Statistical analysis Surgery Surgical drains Thoracic Surgery Treatment Outcome Vascular Surgery Wound drainage |
| title | Percutaneous Transhepatic Gallbladder Intervention as a Bridge to Cholecystectomy: Aspiration or Drainage? |
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