scholarly journals Laparoscopic Subtotal Cholecystectomy after Percutaneous Transhepatic Gallbladder Drainage for a Case of Emphysematous Cholecystitis

2019 ◽  
Vol 44 (1) ◽  
pp. 108-112
Author(s):  
Toshihiko Goto ◽  
Toru Murata
Keyword(s):  
Gallbladder Drainage ◽  
Emphysematous Cholecystitis ◽  
Subtotal Cholecystectomy ◽  
Percutaneous Transhepatic Gallbladder Drainage

scholarly journals THREE PATIENTS WITH ACUTE EMPHYSEMATOUS CHOLECYSTITIS TREATED WITH PERCUTANEOUS TRANSHEPATIC GALLBLADDER DRAINAGE

1998 ◽  
Vol 59 (12) ◽  
pp. 3109-3112 ◽  
Author(s):  
Yoshiyuki TANAKA ◽  
Kazuhiko YAHATA ◽  
Tatsuo TSUYUKUBO ◽  
Yutaka TAMURA ◽  
Masayoshi TANI ◽  
...  
Keyword(s):  
Gallbladder Drainage ◽  
Emphysematous Cholecystitis ◽  
Percutaneous Transhepatic Gallbladder Drainage

scholarly journals Laparoscopic subtotal cholecystectomy after percutaneous transhepatic gallbladder drainage for grade II or III acute cholecystitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masafumi Ie ◽  
Morihiro Katsura ◽  
Yukihiro Kanda ◽  
Takashi Kato ◽  
Kazuya Sunagawa ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Acute Cholecystitis ◽  
Gallbladder Drainage ◽  
Open Conversion ◽  
Subtotal Cholecystectomy ◽  
Conversion Rates ◽  
Significant Difference ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Grade Ii

Abstract Background Severe adhesions and fibrosis between the posterior wall of the gallbladder and liver bed often render total cholecystectomy after percutaneous transhepatic gallbladder drainage (PTGBD) difficult, leading to high open conversion rates. Since the publication of Tokyo Guidelines 2018 (TG18), our policy has shifted from open conversion to subtotal cholecystectomy (SC) when total laparoscopic cholecystectomy for difficult cases of cholecystitis is not feasible. Recently, SC has been frequently applied as bailout surgery for complicated cholecystitis. Nonetheless, the efficacy and validity of laparoscopic SC after PTGBD remain unclear. This study aimed to evaluate the safety and feasibility of laparoscopic SC after PTGBD for grade II or III acute cholecystitis (AC) by comparing two periods of altered surgical strategies. Methods This retrospective cohort study was conducted between January 2013 and December 2020. A total of 44 eligible patients with grade II or III AC were divided according to the time of cholecystitis onset into the pre-TG18 group (2013–2017, n = 17) and post-TG18 group (2018–2020, n = 27). Patients’ background demographics, surgical method, surgical results, and postoperative complications were compared. Results The interval between PTGBD and surgery was significantly longer in the post-TG18 group than in the pre-TG18 group (15 [interquartile range: 9–42] days vs. 8 [4–11] days; P = 0.010). The frequency of laparoscopic cholecystectomy significantly increased from 52.9% in the pre-TG18 group to 88.9% in the post-TG18 group (P = 0.007), whereas the frequency of SC was 23.5% and 40.7%, respectively, which showed no statistically significant difference (P = 0.241). However, the rate of laparoscopic SC significantly increased from 0 to 90.9% among 15 SC cases, whereas the rate of open SC significantly plummeted from 100 to 9.1% (P = 0.001). Significant differences in the operative time, amount of intraoperative bleeding, and incidence of postoperative complications (wound infection and subhepatic abscess) were not observed. Mortality, bile leakage, and bile duct injury did not occur in either group. Conclusions For grade II or III AC after PTGBD, aggressive adoption of SC increased the completion rate of laparoscopic surgery. Laparoscopic SC is a safe and feasible treatment option.

scholarly journals Surgical outcome of percutaneous transhepatic gallbladder drainage in acute cholecystitis: Ten years’ experience at a tertiary care centre

2021 ◽  
Author(s):  
Szabolcs Ábrahám ◽  
Illés Tóth ◽  
Ria Benkő ◽  
Mária Matuz ◽  
Gabriella Kovács ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Acute Cholecystitis ◽  
Conversion Rate ◽  
Clinical Success ◽  
Definitive Treatment ◽  
Success Rates ◽  
Female Ratio ◽  
Gallbladder Drainage ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Grade Iii

Abstract Background Percutaneous transhepatic gallbladder drainage (PTGBD) plays an important role in the treatment of elderly patients and/or patients in poor health with acute cholecystitis (AC). The primary aim of this study is to determine how these factors influence the clinical outcome of PTGBD. Moreover, we assessed the timing and results of subsequent cholecystectomies. Patients and Methods We retrospectively examined the results of 162 patients undergoing PTGBD between 2010 and 2020 (male–female ratio: 51.23% vs. 48.77%; mean age: 71.43 ± 13.22 years). Patient’s performance status and intervention outcomes were assessed with clinical success rates (CSR) and in-hospital mortality. The conversion rate (CR) of possible urgent or delayed, elective laparoscopic cholecystectomies (LC) after PTGBD were analysed. Results PTGBD was the definitive treatment in 42.18% of patients, while it was a bridging therapy prior to cholecystectomy (CCY) for the other patients. CSR was 87.97%, it was only 64.29% in grade III AC. In 9.87% of the cases, urgent LC was necessary after PTGBD, and its conversion rate was approximately equal to that of elective LC (18.18 vs. 17.46%, respectively, p = 0.2217). Overall, the post-PTGBD in-hospital mortality was 11.72%, while the same figure was 0% for grade I AC, 7.41% for grade II and 40.91% for grade III. Based on logistic regression analyses, in-hospital mortality (OR 6.07; CI 1.79–20.56), clinical progression (OR 7.62; CI 2.64–22.05) and the need for emergency CCY (OR 14.75; CI 3.07–70.81) were mostly determined by AC severity grade. Conclusion PTGBD is an easy-to-perform intervention with promising clinical success rates in the treatment of acute cholecystitis. After PTGBD, the level of gallbladder inflammation played a decisive role in the course of AC. In a severe, grade III inflammation, we have to consider low CSR and high mortality.

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