Increased difficulty and complications of delayed laparoscopic cholecystectomy following percutaneous transhepatic gallbladder drainage in acute cholecystitis: a retrospective study.
Acute cholecystitis
Delayed laparoscopic cholecystectomy
Morbidity rate
Percutaneous transhepatic gallbladder drainage
Retrospective study
Journal
BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567
Informations de publication
Date de publication:
13 Sep 2023
13 Sep 2023
Historique:
received:
27
06
2023
accepted:
05
09
2023
medline:
15
9
2023
pubmed:
14
9
2023
entrez:
13
9
2023
Statut:
epublish
Résumé
Percutaneous transhepatic gallbladder drainage (PTGBD) is a relatively less invasive alternative treatment to cholecystostomy. However, the influence of the difficulty of delayed laparoscopic cholecystectomy (DLC) after PTGBD on clinical outcomes remains unknown. This study aimed to evaluate the clinical effects of DLC following PTGBD. The clinical data of 113 patients diagnosed with moderate (grade II) acute cholecystitis according to the 2018 Tokyo Guidelines in the acute phase and who underwent DLC in our hospital from January 2018 to February 2022 were retrospectively collected and separated into two groups according to whether they received PTGBD treatment in the acute stage. The PTGBD group comprised 27 cases, and the no-PTGBD group included 86 cases. The TG18 difficulty score was used to evaluate every surgical procedure in the cases by reviewing the surgical videos. The clinical baseline characteristics and post-treatment outcomes were also evaluated. Both groups showed significant differences in length of postoperative stay, blood loss, operation time, and difficulty score. The PTGBD group showed a significantly longer postoperative stay and operation time, more blood loss, and a much higher difficulty score than the no-PTGBD group. Conversion rates did not differ. The morbidity rate in the PTGBD group was statistically higher. PTGBD is an efficient way to relieve the symptoms of acute cholecystitis. However, it may increase the difficulty and complications of DLC.
Sections du résumé
BACKGROUND
BACKGROUND
Percutaneous transhepatic gallbladder drainage (PTGBD) is a relatively less invasive alternative treatment to cholecystostomy. However, the influence of the difficulty of delayed laparoscopic cholecystectomy (DLC) after PTGBD on clinical outcomes remains unknown. This study aimed to evaluate the clinical effects of DLC following PTGBD.
METHODS
METHODS
The clinical data of 113 patients diagnosed with moderate (grade II) acute cholecystitis according to the 2018 Tokyo Guidelines in the acute phase and who underwent DLC in our hospital from January 2018 to February 2022 were retrospectively collected and separated into two groups according to whether they received PTGBD treatment in the acute stage. The PTGBD group comprised 27 cases, and the no-PTGBD group included 86 cases. The TG18 difficulty score was used to evaluate every surgical procedure in the cases by reviewing the surgical videos. The clinical baseline characteristics and post-treatment outcomes were also evaluated.
RESULTS
RESULTS
Both groups showed significant differences in length of postoperative stay, blood loss, operation time, and difficulty score. The PTGBD group showed a significantly longer postoperative stay and operation time, more blood loss, and a much higher difficulty score than the no-PTGBD group. Conversion rates did not differ. The morbidity rate in the PTGBD group was statistically higher.
CONCLUSIONS
CONCLUSIONS
PTGBD is an efficient way to relieve the symptoms of acute cholecystitis. However, it may increase the difficulty and complications of DLC.
Identifiants
pubmed: 37704959
doi: 10.1186/s12893-023-02185-2
pii: 10.1186/s12893-023-02185-2
pmc: PMC10500720
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
277Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
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 .
doi: 10.1002/jhbp.515
pubmed: 29032636
Mori Y, Itoi T, Baron TH, Takada T, Strasberg SM, Pitt HA, et al. Tokyo Guidelines 2018: management strategies for gallbladder drainage in patients with acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2018;25:87–95. https://doi.org/10.1002/jhbp.504 .
doi: 10.1002/jhbp.504
pubmed: 28888080
Kiviniemi H, Mäkelä JT, Autio R, Tikkakoski T, Leinonen S, Siniluoto T, et al. Percutaneous cholecystostomy in acute cholecystitis in high-risk patients: an analysis of 69 patients. Int Surg. 1998;83:299–302.
pubmed: 10096746
Sugiyama M, Tokuhara M, Atomi Y. Is percutaneous cholecystostomy the optimal treatment for acute cholecystitis in the very elderly? World J Surg. 1998;22:459–63. https://doi.org/10.1007/s002689900416 .
doi: 10.1007/s002689900416
pubmed: 9564288
Chopra S, Dodd GD, Mumbower AL, Chintapalli KN, Schwesinger WH, Sirinek KR, et al. Treatment of acute cholecystitis in non-critically ill patients at high surgical risk: comparison of clinical outcomes after gallbladder aspiration and after percutaneous cholecystostomy. AJR Am J Roentgenol. 2001;176:1025–31. https://doi.org/10.2214/ajr.176.4.1761025 .
doi: 10.2214/ajr.176.4.1761025
pubmed: 11264103
Hultman CS, Herbst CA, McCall JM, Mauro MA. The efficacy of percutaneous cholecystostomy in critically ill patients. Am Surg. 1996;62:263–9.
pubmed: 8600844
Melin MM, Sarr MG, Bender CE, van Heerden JA. Percutaneous cholecystostomy: a valuable technique in high-risk patients with presumed acute cholecystitis. Br J Surg. 1995;82:1274–7. https://doi.org/10.1002/bjs.1800820939 .
doi: 10.1002/bjs.1800820939
pubmed: 7552017
Davis CA, Landercasper J, Gundersen LH, Lambert PJ. Effective use of percutaneous cholecystostomy in high-risk surgical patients: techniques, tube management, and results. Arch Surg. 1999;134. https://doi.org/10.1001/archsurg.134.7.727 . 727 – 31; discussion 731-2.
Wakabayashi G, Iwashita Y, Hibi T, Takada T, Strasberg SM, Asbun HJ, et al. Tokyo Guidelines 2018: surgical management of acute cholecystitis: safe steps in laparoscopic cholecystectomy for acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2018;25:73–86. https://doi.org/10.1002/jhbp.517 .
doi: 10.1002/jhbp.517
pubmed: 29095575
Weigand K, Köninger J, Encke J, Büchler MW, Stremmel W, Gutt CN. Acute cholecystitis – early laparoskopic surgery versus antibiotic therapy and delayed elective cholecystectomy: ACDC-study. Trials. 2007;8:29. https://doi.org/10.1186/1745-6215-8-29 .
doi: 10.1186/1745-6215-8-29
pubmed: 17916243
pmcid: 2098782
Yamada K, Yamashita Y, Yamada T, Takeno S, Noritomi T. Optimal timing for performing percutaneous transhepatic gallbladder drainage and subsequent cholecystectomy for better management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2015;22:855–61. https://doi.org/10.1002/jhbp.294 .
doi: 10.1002/jhbp.294
pubmed: 26479740
Er S, Berkem H, Özden S, Birben B, Çetinkaya E, Tez M, et al. Clinical course of percutaneous cholecystostomies: a cross-sectional study. World J Clin Cases. 2020;8:1033–41. https://doi.org/10.12998/wjcc.v8.i6.1033 .
doi: 10.12998/wjcc.v8.i6.1033
pubmed: 32258074
pmcid: 7103974
Jung WH, Park DE. Timing of cholecystectomy after percutaneous cholecystostomy for acute cholecystitis. Korean J Gastroenterol. 2015;66:209–14.
doi: 10.4166/kjg.2015.66.4.209
pubmed: 26493506
Kamezaki H, Tsuyuguchi T, Shimura K, Sakamoto D, Senoo J, Mizumoto H, et al. Safety and efficacy of early tube removal following percutaneous transhepatic gallbladder drainage: an observational study. Surg Laparosc Endosc Percutan Tech. 2020;30:164–8. https://doi.org/10.1097/SLE.0000000000000761 .
doi: 10.1097/SLE.0000000000000761
pubmed: 31972834
pmcid: 7147403
Woodward SG, Rios-Diaz AJ, Zheng R, McPartland C, Tholey R, Tatarian T, et al. Finding the most favorable timing for cholecystectomy after percutaneous cholecystostomy tube placement: an analysis of institutional and national data. J Am Coll Surg. 2021;232:55–64.
doi: 10.1016/j.jamcollsurg.2020.10.010
pubmed: 33098966