Percutaneous Gallbladder Aspiration Research Articles

Comparison of percutaneous gallbladder aspiration with percutaneous cholecystostomy in acute cholecystostomy patients. Can gall bladder aspiration alone be sufficient?

The aim of this study is to compare the efficacy and complication rates of percutaneous gallbladder aspiration (PA) and percutaneous cholecystostomy (PC) in the management of AC and present the experiences of a single third-line center. The results of 159 patients with AC who admitted to our hospital between 2015 and 2020, that underwent PA and PC procedures, because they did not respond to conservative treatment and LC could not be performed, were retrospectively analyzed. Clinical and laboratory data before and 3 days after PC and PA procedure, technical success, complications, response to treatment, duration of hospital stay, and reverse transcriptase-polymerase chain reaction (RT-PCR) test results were recorded. Out of 159 patients, 22 (8 men 14 women) underwent PA procedure and 137 (57 men 80 women) underwent PC. No significant difference was detected between the PA and PC groups in terms of clinical recovery (P: 0.532) and duration of hospital stay (P: 0.138) in 72 h. The technical success of both procedures was 100%. While 20 out of 22 patients with PA were having a noticable recovery, only one was treated with twice PA procedures and a complete recovery was observed (4.5%). Complication rates were low in both groups and were statistically insignificant (P: 1.00). In this pandemic period, PA and PC procedures are effective, reliable, and successful treatment method that can be applied at the bedside for critical patients with AC who are not compatible with surgery, which are safe for health workers and low-risk minimal invasive procedures for patients. In uncomplicated AC patients, PA should be performed, and if there is no response to treatment, PC should be reserved as a salvage procedure. The PC procedure should be performed in patients with AC who have developed complications and are not suitable for surgery.

Non-surgical Percutaneous Gallbladder Drainage for the Treatment of Acute Cholecystitis: Percutaneous Gallbladder Aspiration: A Systematic Review

Non-surgical Percutaneous Gallbladder Drainage for the Treatment of Acute Cholecystitis: Percutaneous Gallbladder Aspiration: A Systematic Review

Percutaneous aspiration of the gall bladder for the treatment of acute cholecystitis: a prospective study.

Urgent laparoscopic cholecystectomy has been established as the best treatment for acute cholecystitis. However, conservative treatment is advocated for high-risk patients. Failure of conservative treatment can result in high-risk operations with relatively high rates of operative morbidity. Percutaneous cholecystostomy is a good option for these patients. Recently, percutaneous aspiration of the gall bladder without drain has been described. A protocol of initial conservative management in high-operative-risk patients admitted with acute cholecystitis was prospectively assessed. Patients who did not respond to antibiotics were treated with percutaneous trans-hepatic aspiration of the gall bladder under ultrasound guidance. Following discharge, the patients were seen in the outpatient clinic and elective laparoscopic cholecystectomy was considered and scheduled as necessary. Between January 2011 and December 2012, 33 patients with persistent clinical and sonographic signs of acute cholecystitis after failure of initial antibiotic treatment underwent gall bladder aspiration under ultrasound guidance. No complications related to the procedure were reported. In 25 patients (76%), the procedure was successful and they were discharged. Seven patients needed repeated aspiration. Eight patients (24%) who did not improve underwent percutaneous cholecystostomy and were discharged with a drain and later reevaluated for elective surgery. The mean hospital stay of patients with successful aspiration was 3days. During the follow-up period, 23 patients underwent elective interval laparoscopic cholecystectomy. Two were converted to open surgery (8.7%). Conservative treatment and delayed operation is an acceptable option for acute cholecystitis. Percutaneous gall bladder aspiration is a simple and effective procedure, with a high success rate and low morbidity. Laparoscopic cholecystectomy after drainage of the gall bladder has low morbidity with a relatively low conversion rate.

Usefulness of peκutaneous gallbladder aspiration for acute cholecystitis

This study was performed to assess the usefulness of percutaneous gallbladder aspiration for the treatment of acute cholecystitis. Twenty acute cholecystitis patients treated by percutaneous gallbladder aspiration were enrolled in this study and retrospective analysis was performed. Percutaneous gallbladder aspiration was carried out under local anesthesia with ultrasound guidance and 21G puncture needle by percutaneous trans-hepatic approach. Successful therapy was achieved in 18 patients (90%) and the time required to be successful pain control was 0.5-31.5 hours (mean 13.8 hours). 16 patients with mild acute cholecystitis were all successfully treated by the procedure, but two of four patients with moderate acute cholecystitis were failed in treatment There was neither mortality nor major complication related with the procedure. 10 patients (50%) were cured by the procedure and antibiotics medication, and they could be discharged without surgery In addition. 8 of 10 surgical patients (80%) underwent elective surgery and they were able to avoid the risk of emergent or early surgery. Therefore. percutaneous gallbladder aspiration was though to be a useful alternative treatment in the acute cholecystitispatients who couldn’t undergo surgery for some reason. it could be also temporary treatment to avoid relative high-risk emergent or early surgery.

Cholecystitis After Metallic Stent Placement in Patients With Malignant Distal Biliary Obstruction

Cholecystitis after metallic stent (MS) placement is an issue requiring attention. From our experience, cholecystitis seemed to occur mainly in patients with tumor involvement to the cystic duct orifice. The aim of the present study was to identify risk factors for cholecystitis in patients treated with covered or uncovered MS. We analyzed 246 patients who received MS placement (covered MS in 171 and uncovered in 75) between August 1997 and May 2005 for the treatment of unresectable distal malignant biliary obstruction. Causative diseases were as follows: pancreatic cancer in 162, papillary cancer in 10, bile duct cancer in 41, and metastatic nodes in 33 patients. Tumor involvement to orifice of the cystic duct (OCD) was diagnosed based on cholangiography and intraductal ultrasonography. Cholecystitis after MS placement was found in 13 patients (5.3%). There was no significant difference in the incidence of cholecystitis between covered (5.8%) and uncovered (4.0%) MS. By univariate analysis, tumor involvement of the OCD, MS placed above the papilla, and stricture located at midportion were associated significantly with cholecystitis. By multivariate analysis, only tumor involvement of the OCD was a risk factor, with an odds ratio of 47.206 (95% confidence interval, 5.84-381.60). Cholecystitis after MS placement is associated with tumor involvement to the orifice of the cystic duct, regardless of the type of stent.