The Role of Capsule Endoscopy, Balloon-Assisted Enteroscopy and Clinical Parameters in the Management of Patients with Obscure Gastrointestinal Bleeding

Abstract

AIM : The recommended treatment for acute cholecystitis is early laparoscopic cholecystectomy (LC) within 72 hours after onset of symptoms. However, palliative treatment using percutaneous transhepatic gallbladder drainage (PTGBD) is often chosen for clinical and logistical reasons, including difficulty performing early surgery due to manpower constraints. The goal of this study was to investigate the clinical significance of PTGBD on the outcome of patients with cholecystitis in our hospital. MATERIALS AND METHODS : Relationships between preoperative drainage status (treatment with or without PTGBD) and clinicopathologic factors were examined in 190 patients withcholecystitis who underwent LC.The short-term impact of preoperative drainage on prognosis was evaluated by univariate and multivariate analysis. RESULTS : Preoperative PTGBD was performed in 24 patients (12.6%).The average period between PTGBD and LC was 21.0 days. Preoperative PTGBD had a significant correlation with operation time and length of stay (LOS) after surgery (p<0.0001). In patients aged ≥65, preoperative PTGBD was found to be a significant short-term prognostic factor in univariate analysis (LOS: 10.43 vs. 5.39days, p<0.0001) and multivariate analysis (p=0.0488). CONCLUSIONS : Preoperative PTGBDiscorrelated with an extended hospital stay after surgery and is an independent short-term prognostic factor in cholecystitis patients aged ≥65 years old.