Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Ultimate outcomes of three modalities for non-surgical gallbladder drainage in acute cholecystitis with or without concomitant common bile duct stones

  • Wiriyaporn Ridtitid (Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross) ;
  • Thanawat Luangsukrerk (Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross) ;
  • Panida Piyachaturawat (Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross) ;
  • Nicha Teeratorn (Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross) ;
  • Phonthep Angsuwatcharakon (Department of Anatomy, Faculty of Medicine, Chulalongkorn University) ;
  • Pradermchai Kongkam (Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross) ;
  • Rungsun Rerknimitr (Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross)
  • Received : 2021.01.30
  • Accepted : 2021.08.29
  • Published : 2022.02.28
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Abstract

Backgrounds/Aims: In moderate and high-surgical risk patients with acute cholecystitis, studies comparing percutaneous cholecystostomy (PC) vs. endoscopic transpapillary gallbladder stenting (ETGS) vs. endoscopic ultrasound-guided transmural gallbladder stenting (EUGS) are limited. Thus, the aim of this study was to compare efficacy and recurrence of cholecystitis after PC, ETGS, or EUGS during follow-up. Methods: We reviewed 143 moderate and high-surgical risk patients with acute cholecystitis with or without concomitant common bile duct stones who underwent PC, ETGS, or EUGS at our hospital. Technical success rate (TSR), clinical success rate (CSR), and recurrence were compared. Results: TSR in PC or EUGS group was higher than that in the ETGS group for those with concomitant common bile duct stones (100% vs. 100% vs. 73.2%; p = 0.07) and for those without concomitant common bile duct stones (100% vs. 100% vs. 77.3%; p < 0.001). CSR in ETGS or EUGS group was higher than that in the PC group for those with concomitant common bile duct stones (96.2% vs. 100% vs. 87.5%; p = 0.41) and for those without concomitant common bile duct stones (94.1% vs. 100% vs. 63.0%; p = 0.006). Using Kaplan-Meier analysis, the overall recurrent risk was the highest in the PC group (p = 0.004). Conclusions: In moderate and high-surgical risk patients with acute cholecystitis, EUGS provides significantly higher CSR with comparable TSR to PC. Thus, ETGS should be the first choice in those with concomitant common bile duct stones. Among the three patient groups, those who received PC had the highest rate of recurrence.

Keywords

Acknowledgement

An earlier version of these data has been selected for presentation at the annual meeting of Digestive Diseases Week, 2020, Chicago, Illinois, USA.

References

  1. Iino C, Shimoyama T, Igarashi T, Aihara T, Ishii K, Sakamoto J, et al. Comparable efficacy of endoscopic transpapillary gallbladder drainage and percutaneous transhepatic gallbladder drainage in acute cholecystitis. Endosc Int Open 2018;6:E594-E601. https://doi.org/10.1055/s-0044-102091
  2. Okamoto K, Suzuki K, Takada T, Strasberg SM, Asbun HJ, Endo I, et al. Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. J Hepatobiliary Pancreat Sci 2018;25:55-72. https://doi.org/10.1002/jhbp.516
  3. Boules M, Haskins IN, Farias-Kovac M, Guerron AD, Schechtman D, Samotowka M, et al. What is the fate of the cholecystostomy tube following percutaneous cholecystostomy? Surg Endosc 2017;31:1707-1712. https://doi.org/10.1007/s00464-016-5161-x
  4. Siddiqui A, Kunda R, Tyberg A, Arain MA, Noor A, Mumtaz T, et al. Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis: clinical outcomes and success in an International, Multicenter Study. Surg Endosc 2019;33:1260-1270. https://doi.org/10.1007/s00464-018-6406-7
  5. Higa JT, Sahar N, Kozarek RA, La Selva D, Larsen MC, Gan SI, et al. EUS-guided gallbladder drainage with a lumen-apposing metal stent versus endoscopic transpapillary gallbladder drainage for the treatment of acute cholecystitis (with videos). Gastrointest Endosc 2019;90:483-492. https://doi.org/10.1016/j.gie.2019.04.238
  6. Itoi T, Coelho-Prabhu N, Baron TH. Endoscopic gallbladder drainage for management of acute cholecystitis. Gastrointest Endosc 2010;71:1038-1045. https://doi.org/10.1016/j.gie.2010.01.026
  7. Oh D, Song TJ, Cho DH, Park DH, Seo DW, Lee SK, et al. EUS-guided cholecystostomy versus endoscopic transpapillary cholecystostomy for acute cholecystitis in high-risk surgical patients. Gastrointest Endosc 2019;89:289-298. https://doi.org/10.1016/j.gie.2018.08.052
  8. Irani S, Ngamruengphong S, Teoh A, Will U, Nieto J, Abu Dayyeh BK, et al. Similar efficacies of endoscopic ultrasound gallbladder drainage with a lumen-apposing metal stent versus percutaneous transhepatic gallbladder drainage for acute cholecystitis. Clin Gastroenterol Hepatol 2017;15:738-745. https://doi.org/10.1016/j.cgh.2016.12.021
  9. Anderloni A, Buda A, Vieceli F, Khashab MA, Hassan C, Repici A. Endoscopic ultrasound-guided transmural stenting for gallbladder drainage in high-risk patients with acute cholecystitis: a systematic review and pooled analysis. Surg Endosc 2016;30:5200-5208. https://doi.org/10.1007/s00464-016-4894-x
  10. Salameh H, DiMaio CJ. Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided gallbladder drainage. Gastrointest Endosc Clin N Am 2019;29:293-310. https://doi.org/10.1016/j.giec.2018.12.002
  11. Johlin FC Jr, Neil GA. Drainage of the gallbladder in patients with acute acalculous cholecystitis by transpapillary endoscopic cholecystotomy. Gastrointest Endosc 1993;39:645-651. https://doi.org/10.1016/S0016-5107(93)70216-3
  12. Ridtitid W, Piyachaturawat P, Teeratorn N, Angsuwatcharakon P, Kongkam P, Rerknimitr R. Single-operator peroral cholangioscopy cystic duct cannulation for transpapillary gallbladder stent placement in patients with acute cholecystitis at moderate to high surgical risk (with videos). Gastrointest Endosc 2020;92:634-644. https://doi.org/10.1016/j.gie.2020.03.3866
  13. McCarthy ST, Tujios S, Fontana RJ, Rahnama-Moghadam S, Elmunzer BJ, Kwon RS, et al. Endoscopic transpapillary gallbladder stent placement is safe and effective in high-risk patients without cirrhosis. Dig Dis Sci 2015;60:2516-2522. https://doi.org/10.1007/s10620-014-3371-4
  14. Maekawa S, Nomura R, Murase T, Ann Y, Oeholm M, Harada M. Endoscopic gallbladder stenting for acute cholecystitis: a retrospective study of 46 elderly patients aged 65 years or older. BMC Gastroenterol 2013;13:65.
  15. Lee TH, Park DH, Lee SS, Seo DW, Park SH, Lee SK, et al. Outcomes of endoscopic transpapillary gallbladder stenting for symptomatic gallbladder diseases: a multicenter prospective follow-up study. Endoscopy 2011;43:702-708. https://doi.org/10.1055/s-0030-1256226
  16. Kjaer DW, Kruse A, Funch-Jensen P. Endoscopic gallbladder drainage of patients with acute cholecystitis. Endoscopy 2007;39:304-308. https://doi.org/10.1055/s-2007-966335
  17. Irani S, Baron TH, Grimm IS, Khashab MA. EUS-guided gallbladder drainage with a lumen-apposing metal stent (with video). Gastrointest Endosc 2015;82:1110-1115. https://doi.org/10.1016/j.gie.2015.05.045
  18. Khan MA, Atiq O, Kubiliun N, Ali B, Kamal F, Nollan R, et al. Efficacy and safety of endoscopic gallbladder drainage in acute cholecystitis: is it better than percutaneous gallbladder drainage? Gastrointest Endosc 2017;85:76-87.e3. https://doi.org/10.1016/j.gie.2016.06.032
  19. Mohan BP, Asokkumar R, Shakhatreh M, Garg R, Ponnada S, Navaneethan U, et al. Adverse events with lumen-apposing metal stents in endoscopic gallbladder drainage: a systematic review and meta-analysis. Endosc Ultrasound 2019;8:241-248. https://doi.org/10.4103/eus.eus_63_18
  20. Mohan BP, Khan SR, Trakroo S, Ponnada S, Jayaraj M, Asokkumar R, et al. Endoscopic ultrasound-guided gallbladder drainage, transpapillary drainage, or percutaneous drainage in high risk acute cholecystitis patients: a systematic review and comparative meta-analysis. Endoscopy 2020;52:96-106. https://doi.org/10.1055/a-1020-3932
  21. Yokoe M, Hata J, Takada T, Strasberg SM, Asbun HJ, Wakabayashi G, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci 2018;25:41-54. https://doi.org/10.1002/jhbp.515
  22. Buxbaum JL, Abbas Fehmi SM, Sultan S, Fishman DS, Qumseya BJ, Cortessis VK, et al. ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis. Gastrointest Endosc 2019;89:1075-1105.e15. https://doi.org/10.1016/j.gie.2018.10.001
  23. Rerknimitr R, Pham KC. Practical approaches for high-risk surgical patients with acute cholecystitis: the percutaneous approach versus endoscopic alternatives. Clin Endosc 2020;53:678-685. https://doi.org/10.5946/ce.2019.186
  24. Yoshida M, Naitoh I, Hayashi K, Jinno N, Hori Y, Natsume M, et al. Four-step classification of endoscopic transpapillary gallbladder drainage and the practical efficacy of cholangioscopic assistance. Gut Liver 2021;15:476-485. https://doi.org/10.5009/gnl20238
  25. Tomimaru Y, Fukuchi N, Yokoyama S, Mori T, Tanemura M, Sakai K, et al. Optimal timing of laparoscopic cholecystectomy after gallbladder drainage for acute cholecystitis: a multi-institutional retrospective study. J Hepatobiliary Pancreat Sci 2020;27:451-460. https://doi.org/10.1002/jhbp.768
  26. Saumoy M, Tyberg A, Brown E, Eachempati SR, Lieberman M, Afaneh C, et al. Successful cholecystectomy after endoscopic ultrasound gallbladder drainage compared with percutaneous cholecystostomy, can it be done? J Clin Gastroenterol 2019;53:231-235. https://doi.org/10.1097/MCG.0000000000001036
  27. Teoh AY, Perez-Miranda M, Kunda R, Lee SS, Irani S, Yeaton P, et al. Outcomes of an international multicenter registry on EUS-guided gallbladder drainage in patients at high risk for cholecystectomy. Endosc Int Open 2019;7:E964-E973.  https://doi.org/10.1055/a-0915-2098