title: Usefulness of single and repetitive percutaneous transhepatic gallbladder aspiration for the treatment of acute cholecystitis.
abstract: BACKGROUND
  The aim of this study was to evaluate the safety and usefulness of single and repetitive percutaneous transhepatic gallbladder aspiration (PTGBA) for the treatment of acute cholecystitis.
  
  
  METHODS
  PTGBA was performed in patients with acute cholecystitis who showed no improvement after treatment with broad-spectrum antibiotics. PTGBA was carried out at bedside. When the bile was too thick to be aspirated through a 21-gauge needle, an 18-gauge needle was used. Aspiration of the gallbladder contents and injection of antibiotics into the gallbladder were performed without the placement of a drainage catheter. When improvement was not observed after the first attempt, PTGBA was repeated.
  
  
  RESULTS
  Single PTGBA achieved improvement in 32 of 45 patients. In 11 of the remaining 13 patients, the second PTGBA was effective. In the remaining two patients, repetitive PTGBA was not carried out because of advanced cancer. In two of 45 patients, 18-gauge needles were necessary for PTGBA because of the high viscosity of the bile. PTGBA was carried out in three patients with blockage of the cystic duct by a stent, and it was effective in all three. Two patients whose conditions improved with a single PTGBA experienced a recurrence at 4 and 31 months, respectively, after PTGBA. No other severe complications related to PTGBA were observed in any patients.
  
  
  CONCLUSIONS
  For the treatment of acute cholecystitis that does not react to conservative therapies, PTGBA is a safe, simple, and effective treatment modality that can be performed at bedside without any severe complications.
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tsutsui
authors.forename: Naohito
authors.initials: N
authors.lastname: Uchida
authors.forename: Shuko
authors.initials: S
authors.lastname: Hirabayashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Kamada
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ono
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Ogawa
authors.forename: Toru
authors.initials: T
authors.lastname: Ezaki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Fukuma
authors.forename: Hideki
authors.initials: H
authors.lastname: Kobara
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Aritomo
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Masaki
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Nakatsu
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kuriyama
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D041881:Cholecystitis, Acute / Q000628:therapy*; D003131:Combined Modality Therapy; D003549:Cystic Duct / Q000473:pathology; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005704:Gallbladder; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D012008:Recurrence; D015607:Stents / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents