Endoscopic gallbladder drainage compared with percutaneous drainage

      Background

      High-risk patients with cholecystitis have conventionally been offered percutaneous gallbladder drainage (PGBD) for treatment. A growing experience of endoscopic gallbladder drainage (EGBD) has been reported to be effective and safe.

      Objective

      To compare the short- and long-term outcomes of EGBD and PGBD.

      Design

      A retrospective review.

      Setting

      Single academic tertiary care center.

      Patients

      Inpatients diagnosed with cholecystitis.

      Interventions

      Any patient deemed a nonsurgical candidate and who has undergone either PGBD or EGBD was included in the analysis.

      Main Outcome Measurements

      Patient demographics along with procedural and clinical outcomes were recorded for each group.

      Results

      Forty-three patients underwent PGBD and 30 underwent EGBD (24 transpapillary, 6 transmural). Technical (97.6% vs 100%) and clinical (97.6% vs 86.7%) success rates of PGBD and EGBD were similar. However, postprocedure hospital length of stay (16.3 vs 7.6 days), time to clinical resolution (4.6 vs 3.0 days), adverse event rate (39.5% vs 13.3%), number of sessions (2.0 vs 1.0), number of repeat interventions (53.4% vs 13.3%), and postprocedure pain scores (3.8 vs 2.1) were significantly higher for PGBD than EGBD.

      Limitations

      Retrospective analysis.

      Conclusion

      Although EGBD has similar technical and clinical success compared with PGBD, it uses fewer hospital resources and results in fewer adverse events, improved pain scores, and decreased need for repeat gallbladder drainage. EGBD may provide a less-invasive, safer, cost-effective option for gallbladder drainage than PGBD with improved clinical outcomes.

      Abbreviations:

      EGBD (endoscopic gallbladder drainage), PGBD (percutaneous gallbladder drainage)
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