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- Title
Long‐term outcomes of endoscopic ultrasound‐guided gallbladder drainage versus in situ or ex situ percutaneous gallbladder drainage in real‐world practice.
- Authors
Cho, Sung Hyun; Oh, Dongwook; Song, Tae Jun; Gwon, Dong Il; Ko, Gi‐Young; Ko, Heung‐Kyu; Park, Do Hyun; Seo, Dong‐Wan; Lee, Sung Koo; Kim, Myung‐Hwan; Lee, Sang Soo
- Abstract
Objectives: Many studies showed better outcomes of endoscopic ultrasound‐guided gallbladder drainage (EUS‐GBD) when compared with percutaneous transhepatic gallbladder drainage (P‐GBD) in which most tubes were left in situ. However, no studies have directly compared EUS‐GBD with P‐GBD after tube removal (ex situ). We compared the long‐term outcomes of EUS‐GBD and ex situ or in situ P‐GBD in high surgical risk patients with acute cholecystitis. Methods: We reviewed the records of 182 patients (EUS‐GBD, n = 75; P‐GBD, n = 107) who underwent gallbladder drainage. The procedural outcomes, long‐term outcomes, and adverse events were compared. Results: The EUS‐GBD group and the P‐GBD group had similar rates of technical and clinical success. Early adverse events were less common in the EUS‐GBD group (5.5% vs. 18.9%, P = 0.010). The long‐term outcomes were evaluated in 168 patients (EUS‐GBD, n = 67; P‐GBD ex situ, n = 84; P‐GBD in situ, n = 17). The rate of cholecystitis recurrence in the EUS‐GBD group (6.0%) was similar to that in the P‐GBD ex situ group (9.6%, P = 0.422), but significantly lower than that in the P‐GBD in situ group (23.5%, P = 0.049). P‐GBD in situ was a significant predictor of recurrent cholecystitis (hazard ratio 14.6; 95% confidence interval 2.9–72.8). Conclusion: The long‐term recurrence rate of acute cholecystitis in patients who underwent EUS‐GBD was comparable to that in patients whose P‐GBD could be removed. However, patients in whom P‐GBD could not be removed showed higher rates of recurrent cholecystitis than patients with EUS‐GBD.
- Subjects
ENDOSCOPIC ultrasonography; GALLBLADDER; MEDICAL device removal; CHOLECYSTITIS; CONFIDENCE intervals
- Publication
Digestive Endoscopy, 2023, Vol 35, Issue 5, p658
- ISSN
0915-5635
- Publication type
Article
- DOI
10.1111/den.14485