Abstract
BackgroundPercutaneous transhepatic gallbladder drainage (PTGBD) is indicated for patients with acute cholecystitis (AC) who are not indicated for urgent surgery, but external tubes reduce quality of life (QOL) while waiting for elective surgery. The objective of the present study was to investigate the feasibility of laparoscopic cholecystectomy after endoscopic trans-papillary gallbladder stenting (ETGBS) comparing with after PTGBD.MethodsIntraoperative and postoperative outcomes of patients with ETGBS and PTGBD were retrospectively compared.ResultsEighteen ETGBS and ten PTGBD patients were compared. Differences in the duration of ETGBS and PTGBD [median 209 min (range 107–357) and median 161 min (range 130–273), respectively, P = 0.10], median blood loss [ETGBS 2 (range 2–180 ml) and PTGBD 24 (range 2–100 ml), P = 0.89], switch to laparotomy (ETGBS 11% and PTGBD 20%, P = 0.52), and median postoperative hospital stay [ETGBS 8 (range 4–24 days) and ETGBS 8 (range 4–16 days), P = 0.99]. Thickening of the cystic duct that occurred in 60% of the ETGBS patients and none of the PTGBD patients (P = 0.005) interfered with closure of the duct by clipping. No obstruction occurred in ETGBS patients.ConclusionETGBS did not make laparoscopic cholecystectomy less feasible than after PTGBD. This is a pilot study, and further investigations are needed to validate the results of the present study.
Highlights
Percutaneous transhepatic gallbladder drainage (PTGBD) is indicated for patients with acute cholecystitis (AC) who are not indicated for urgent surgery, but external tubes reduce quality of life (QOL) while waiting for elective surgery
Some reports have focused on the short-term outcomes after laparoscopic cholecystectomy (LC) with gallbladder drainage including both PTGBD and endoscopic trans-papillary gallbladder stenting (ETGBS), no reports have addressed the feasibility of LC for AC after ETGBS comparing with LC after PTGBD [9,10,11,12,13]
It has become the first choice for gallbladder drainage in our institution because we consider that an internalized tube of ETGBS has the advantage of maintaining the patient’s quality of life during the waiting time prior to surgery when compared with the externalized tube of PTGBD
Summary
Percutaneous transhepatic gallbladder drainage (PTGBD) is indicated for patients with acute cholecystitis (AC) who are not indicated for urgent surgery, but external tubes reduce quality of life (QOL) while waiting for elective surgery. The objective of the present study was to investigate the feasibility of laparoscopic cholecystectomy after endoscopic trans-papillary gallbladder stenting (ETGBS) comparing with after PTGBD. Percutaneous transhepatic gallbladder drainage (PTGBD), an effective and safe drainage procedure, has been used since the 1970s [3,4,5] but requires external tubes that might decrease the quality of life (QOL) during the waiting period before elective surgery can be performed. As a drainage tool for AC, endoscopic trans-papillary gallbladder stenting (ETGBS) has been reported as an alternative to PTGBD. The present study was considered as pilot study due to immature and small sample size from single institution
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