3:00 PM Abstract No. 99 ■ DISTINGUISHED ABSTRACT Gallbladder cryoablation for chronic cholecystitis in high-risk surgical patients: early clinical experience and imaging follow-up

Abstract

To assess the short-term safety and efficacy of gallbladder cryoablation in high-risk patients. Patients with cholecystitis previously treated with a cholecystostomy tube (n = 6) or biliary colic (n = 1), who were referred for gallbladder cryoablation between August 2018 and July 2019 were followed clinically and with imaging for 3-12 months. All patients had significant preprocedural comorbidities and were deemed unacceptable surgical candidates by an attending surgeon. Primary efficacy measures were technical success of the procedure, absence of symptoms at 1 month, and imaging evidence of cystic duct obstruction and gallbladder devitalization. The primary safety measure was the presence/absence of the Society of Interventional Radiology’s moderate or greater adverse events. There was no peri-procedure, early (<30 day), or in-hospital mortality. Technical success was 86% with 1 of 7 patients unable to undergo cryoablation because of adhesions preventing hydrodissection of the colon away from the gallbladder. Abdominal pain was absent in all patients 1 month after ablation. At least 1 CT or MR was completed 1-6 months after ablation and demonstrated evidence of gallbladder involution in 4/6 patients. Hepatobiliary iminodiacetic acid scans were completed in 5/6 patients 1 month after ablation and demonstrated cystic duct occlusion in all 5 patients. One moderate and 1 life-threatening adverse event occurred. These early outcomes suggest that gallbladder cryoablation may be a viable treatment option for high-risk patients with gallbladder disease and warrant further investigation.