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)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 05, 2015
Accepted:
March 5,
2015
Received:
October 9,
2014
Footnotes
DISCLOSURE: The following author disclosed financial relationships relevant to this publication: M. Kahaleh: Consultant for Boston Scientific and Xlumena; Research grants from Boston Scientific, Fuji, Pentax, MI Tech, EMcision, ASPIRE Bariatrics, GI Dynamics, W.L. Gore Associates, Cook Endoscopy, Apollo Endosurgery, and MaunaKea Tech. All other authors disclosed no financial relationships relevant to this publication.
See CME section; p. 1105.
Identification
Copyright
© 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
