دورية أكاديمية
Similar Efficacies of Endoscopic Ultrasound Gallbladder Drainage With a Lumen-Apposing Metal Stent Versus Percutaneous Transhepatic Gallbladder Drainage for Acute Cholecystitis.
| العنوان: | Similar Efficacies of Endoscopic Ultrasound Gallbladder Drainage With a Lumen-Apposing Metal Stent Versus Percutaneous Transhepatic Gallbladder Drainage for Acute Cholecystitis. |
|---|---|
| المؤلفون: | Irani S; Division of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, Washington. Electronic address: shayan.irani@virginiamason.org., Ngamruengphong S; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland., Teoh A; Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong., Will U; Department of Gastroenterology, Municipal Hospital, Gera, Germany., Nieto J; Advanced Therapeutic Endoscopy Center, Borland Groover Clinic, Jacksonville, Florida., Abu Dayyeh BK; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Gan SI; Division of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, Washington., Larsen M; Division of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, Washington., Yip HC; Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong., Topazian MD; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Levy MJ; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Thompson CC; Division of Gastroenterology and Hepatology, Brigham and Women's Hospital, Boston, Massachusetts., Storm AC; Division of Gastroenterology and Hepatology, Brigham and Women's Hospital, Boston, Massachusetts., Hajiyeva G; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland., Ismail A; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland., Chen YI; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland., Bukhari M; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland., Chavez YH; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland., Kumbhari V; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland., Khashab MA; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland. |
| المصدر: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2017 May; Vol. 15 (5), pp. 738-745. Date of Electronic Publication: 2016 Dec 30. |
| نوع المنشور: | Comparative Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: W.B. Saunders for the American Gastroenterological Association Country of Publication: United States NLM ID: 101160775 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1542-7714 (Electronic) Linking ISSN: 15423565 NLM ISO Abbreviation: Clin Gastroenterol Hepatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Philadelphia, PA : W.B. Saunders for the American Gastroenterological Association, 2003- |
| مواضيع طبية MeSH: | Cholecystitis, Acute/*surgery , Drainage/*methods , Gallbladder/*surgery, Adult ; Aged ; Aged, 80 and over ; Drainage/adverse effects ; Endosonography/methods ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome |
| مستخلص: | Background & Aims: Acute cholecystitis in patients who are not candidates for surgery is often managed with percutaneous transhepatic gallbladder drainage (PT-GBD). Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with a lumen-apposing metal stent (LAMS) is an effective alternative to PT-GBD. We compared the technical success of EUS-GBD versus PT-GBD, and patient outcomes, numbers of adverse events (AEs), length of hospital stay, pain scores, and repeat interventions. Methods: We performed a retrospective study to compare EUS-GBD versus PT-GBD at 7 centers (5 in the United States, 1 in Europe, and 1 in Asia), from 2013 through 2015, in management of acute cholecystitis in patients who are not candidates for surgery. A total of 90 patients (56 men) with acute cholecystitis (61 calculous, 29 acalculous) underwent EUS-GBD (n = 45) or PT-GBD (n = 45). Data were collected on technical success, clinical success (resolution of symptoms or laboratory and/or radiologic abnormalities within 3 days of intervention), and need for repeat intervention. Characteristics were compared using Student t tests for continuous variables and the chi-square test, or the Fisher exact test, when appropriate, for categorical variables. Adverse events were graded according to American Society for Gastrointestinal Endoscopy definitions and compared using the Fisher exact test. Postprocedure pain scores were compared using the Mann-Whitney U test. Results: Baseline characteristics, type, and clinical severity of cholecystitis were comparable between groups. In the EUS-GBD group, noncautery LAMS were used in 30 patients and cautery-enhanced LAMS were used in 15. Technical success was achieved for 98% of patients in the EUS-GBD and 100% of the patients in the PT-GBD group (P = .88). Clinical success was achieved by 96% of patients in the EUS-GBD group and 91% in the PT-GBD group (P = .20). There was a nonsignificant trend toward fewer AEs in the EUS-GBD group (5 patients; 11%) than in the PT-GBD group (14 patients; 32%) (P = .065). There were no significant differences in the severity of the AEs: mild, 2 in the EUS-GBD group versus 5 in the PT-GBD group (P = .27); moderate, 4 versus 3 (P = .98); severe, 1 versus 3 (P = .62); or deaths, 1 versus 3 (P = .61). The mean postprocedure pain score was lower in the EUS-GBD group than in the PT-GBD group (2.5 vs 6.5; P < .05). The EUS-GBD group had a shorter average length of stay in the hospital (3 days) than the PT-GBD group (9 days) (P < .05) and fewer repeat interventions (11 vs 112) (P < .05). The average number of repeat interventions per patients was 0.2 ± 0.4 EUS-GBD group versus 2.5 ± 2.8 in the PT-GBD group (P < .05). Median follow-up after drainage was comparable in EUS-GBD group (215 days; range, 1-621 days) versus the PT-GBD group (265 days; range, 1-1638 days). Conclusions: EUS-GBD has similar technical and clinical success compared with PT-GBD and should be considered an alternative for patients who are not candidates for surgery. Patients who undergo EUS-GBD seem to have shorter hospital stays, lower pain scores, and fewer repeated interventions, with a trend toward fewer AEs. A prospective, comparative study is needed to confirm these results. (Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Liver; Nonsurgical Candidate; Transmural Gallbladder Drainage |
| تواريخ الأحداث: | Date Created: 20170104 Date Completed: 20180102 Latest Revision: 20220409 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.cgh.2016.12.021 |
| PMID: | 28043931 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1542-7714 |
|---|---|
| DOI: | 10.1016/j.cgh.2016.12.021 |