title: Current role of percutaneous transhepatic gallbladder aspiration: from palliative to curative management for acute cholecystitis.
abstract: BACKGROUND
  The present study assessed conservative management of acute cholecystitis (AC) with a focus on percutaneous transhepatic gallbladder aspiration (PTGBA).
  
  
  METHODS
  Consecutive 275 patients with AC who underwent PTGBA were reviewed. Patients aged ≥80 years and/or with American Society of Anesthesiologists score III to IV and/or performance status 3 to 4 were defined as high risk. Patients were classified according to duration from symptom onset to first PTGBA: within 3 days (early PTGBA) or over 3 days (late PTGBA). They were also classified according to duration from first PTGBA to surgery: within 30 days (early surgery) or over 30 days (late surgery).
  
  
  RESULTS
  A total of 263 patients (95.6%) showed recovery after PTGBA. There were no significant differences in operating time, blood loss, operating procedure, conversion rate to open surgery, postoperative complications, or postoperative hospital stay between the early and late PTGBA groups or between the early and late surgery groups. No significant complications associated with PTGBA or surgery were observed, including in those at high risk.
  
  
  CONCLUSIONS
  Percutaneous transhepatic gallbladder aspiration can be a useful alternative for most patients with AC, including those at high risk. Elective cholecystectomy can be performed safely regardless of the timing of PTGBA or surgery.
authors: Department of Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa-ku, Osaka, 533-0024, Japan.
authors: Shohei
authors: S
authors: Komatsu
authors: Department of Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa-ku, Osaka, 533-0024, Japan.
authors: Shinobu
authors: S
authors: Tsuchida
authors: Department of Surgery, Osaka City Juso Hospital, Osaka, Japan.
authors: Tadashi
authors: T
authors: Tsukamoto
authors: Department of Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa-ku, Osaka, 533-0024, Japan.
authors: Tomoyuki
authors: T
authors: Wakahara
authors: Department of Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa-ku, Osaka, 533-0024, Japan.
authors: Hiroshi
authors: H
authors: Ashitani
authors: Department of Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa-ku, Osaka, 533-0024, Japan.
authors: Nozomi
authors: N
authors: Ueno
authors: Department of Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa-ku, Osaka, 533-0024, Japan.
authors: Akihiro
authors: A
authors: Toyokawa
authors: Department of Gastroenterology, Yodogawa Christian Hospital, Osaka, Japan.
authors: Akihiko
authors: A
authors: Watanabe
authors: Department of Gastroenterology, Yodogawa Christian Hospital, Osaka, Japan.
authors: Atsushi
authors: A
authors: Sugahara
authors: Department of Gastroenterology, Yodogawa Christian Hospital, Osaka, Japan.
authors: Hidekazu
authors: H
authors: Mukai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D000072700:Conservative Treatment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012380:Role; D012720:Severity of Illness Index; D013396:Suction / Q000379:methods*; D016896:Treatment Outcome
keywords: Acute cholecystitis; Elective cholecystectomy; Percutaneous transhepatic gallbladder aspiration