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- W2289773806 abstract "The first line management of acute cholecystitis remains surgery for patients who are good operative candidates. In high-risk operative candidates, a conservative approach of intravenous fluids and antibiotics is recommended. In those who fail conservative management, nonsurgical decompression of the gallbladder is urgently needed to prevent sepsis, perforation and death. Percutaneous gallbladder drainage (PTGBD) has been described since the 1970s [Elyaderani and Gabriele, 1979]. This can be performed with gallbladder puncture under transabdominal ultrasound or computed tomography (CT) guidance followed by placement of an indwelling 6-10 French pigtail catheter drain [Akhan et al. 2002]. This technique has been well studied with prospective data and randomized trials showing success rates upwards of 95% [Ito et al. 2004; Hatzidakis et al. 2002; Sugiyama et al. 1998]. However, PTGBD has significant complications including bleeding, bile leak, bile peritonitis, pneumothorax, bowel perforation, secondary infections and catheter dislodgement [Akhan et al. 2002]. In addition, it cannot be performed in patients with ascites or those on anticoagulants. The need for leaving an exterior drainage tube can be burdensome and uncomfortable, requiring multiple sessions [Kedia et al. 2015] and tube dislodgement occurs in 0.3–12% of patients [Ito et al. 2004, Hatzidakis et al. 2002, Kiviniemi et al. 1998]. Interestingly percutaneous drainage of the gallbladder has been increasingly used in an attempt to ‘cool off’ the gallbladder and facilitates a future resection." @default.
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- W2289773806 date "2015-11-30" @default.
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- W2289773806 title "EUS-guided transmural gallbladder drainage: a new era has begun" @default.
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- W2289773806 doi "https://doi.org/10.1177/1756283x15618178" @default.
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