Percutaneous gallbladder aspiration for acute cholecystitis.
Early cholecystectomy for patients with acute cholecystitis may not be possible in some clinical settings. Percutaneous gallbladder aspiration (PGBA) offers an alternative approach, but the benefits and risks of this procedure are unclear. We synthesized data on the outcomes of PGBA in acute cholecystitis patients using data sources from online databases, including MEDLINE and EMBASE, and bibliographies of included studies from January 2000 through December 2015. Two reviewers independently reviewed and critiqued the quality of each study. Seven eligible studies met our criteria. The success rates in single PGBA and repetitive PGBA (2-4 times) were 50% to 93% and 76% to 96%, respectively. Complication rates were 0% to 8% and were unrelated to the size of needle gauge used for aspiration and the number of aspirations. Salvage percutaneous cholecystostomy (PC) and urgent surgery were required in 0% to 43% of patients and 0% to 4% of patients, respectively. Two studies with antibiotic instillation had clinical success rates of 95% and 96%. In conclusion, repetitive PGBA combined with antibiotic instillation and salvage PC are useful alternatives to early cholecystectomy in patients with acute cholecystitis.
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.
Supannee
S
Rassameehiran
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.
Pakpoom
P
Tantrachoti
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.
Kenneth
K
Nugent
Clin Gastroenterol Hepatol. 2010 Jan;8(1):15-22
19747982
AJR Am J Roentgenol. 2001 Apr;176(4):1025-31
11264103
Surg Endosc. 2016 May;30(5):1948-51
26201413
J Clin Epidemiol. 2011 Apr;64(4):380-2
21185693
Gastrointest Endosc. 2010 May;71(6):1038-45
20438890
Lancet. 1993 May 1;341(8853):1132-3
8097814
J Gastroenterol. 2007 Jul;42(7):583-8
17653655
J Clin Gastroenterol. 2013 Mar;47(3):288-90
23328303
J Dig Dis. 2014 Dec;15(12):669-75
25233857
HPB Surg. 1991;3(3):167-75; discussion 175-6
2043514
Int J Clin Pract. 2005 Jan;59(1):21-4
15707459
AJR Am J Roentgenol. 2004 Jul;183(1):193-6
15208137
BMJ. 2011 Oct 18;343:d5928
22008217