title: Percutaneous and endoscopic gallbladder drainage for acute cholecystitis: international multicenter comparative study using propensity score-matched analysis.
abstract: BACKGROUND
  Tokyo Guideline 2013 (TG13) proposed three drainage techniques for the treatment of acute cholecystitis. We evaluated the clinical efficacy and adverse events between percutaneous transhepatic intervention (PTGBI) including percutaneous transhepatic gallbladder drainage (PTGBD) and percutaneous transhepatic gallbladder aspiration (PTGBA) and endoscopic transpapillary gallbladder drainage (EGBD).
  
  
  METHODS
  A cohort study was performed using propensity score matching to reduce treatment selection bias. This involved the analysis of collected data for 1,764 patients who underwent PTGBI and EGBD.
  
  
  RESULTS
  Propensity score matching extracted 330 pairs of patients. The difference in the clinical success rate within 3 days between PTGBI and EGBD were 62.5% and 69.8%, respectively (P = 0.085). The differences in the suboptimal clinical success rates within 7 days between PTGBI and EGBD were 87.6% and 89.2% (P = 0.579). The differences in the complication rate between PTGBI and EGBD were 4.8% and 8.2% (P = 0.083). The differences in the complication rate among PTGBD, PTGBA and EGBD were 5.6%, 1.6% and 8.2% (P = 0.11). Median required days of PTGBD (3.0 days) was significantly longer than those of PTGBA and EGBD (1.5 and 2.0 days, respectively) (P = 0.001).
  
  
  CONCLUSIONS
  The current study showed the PTGBI showed similar clinical efficacy compared with EGBD without significant discrepancy of complication rate for the treatment of acute cholecystitis.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.affiliation: Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.affiliation: Division of General Surgery, Lin-Kou Chang Gung Memorial Hospital, Tauyuan, Taiwan.
authors.forename: Tsann-Long
authors.initials: TL
authors.lastname: Hwang
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Kanagawa, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
authors.affiliation: Department of medical informatics, Niigata University, Niigata, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Akazawa
authors.affiliation: Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Miura
authors.affiliation: Division of General Surgery, Lin-Kou Chang Gung Memorial Hospital, Tauyuan, Taiwan.
authors.forename: Miin-Fu
authors.initials: MF
authors.lastname: Chen
authors.affiliation: Division of General Surgery, Lin-Kou Chang Gung Memorial Hospital, Tauyuan, Taiwan.
authors.forename: Yi-Yin
authors.initials: YY
authors.lastname: Jan
authors.affiliation: Department of Surgery, Yuan's General Hospital, Kaohsiung, Taiwan.
authors.forename: Chen-Guo
authors.initials: CG
authors.lastname: Ker
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Hsiu-Po
authors.initials: HP
authors.lastname: Wang
authors.affiliation: Center for Global Health Mito Kyodo General Hospital University of Tsukuba, Ibaraki, Japan.
authors.forename: Harumi
authors.initials: H
authors.lastname: Gomi
authors.affiliation: Department of General Internal Medicine, Japanese Red Cross Nagoya Daini Hospital, Aichi, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Yokoe
authors.affiliation: Department of Gastroenterology, Ogaki Municipal Hospital, Gifu, Japan.
authors.forename: Seiki
authors.initials: S
authors.lastname: Kiriyama
authors.affiliation: Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Wada
authors.affiliation: Second Department of Surgery, Wakayama Medical University School of Medicine, Wakayama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
authors.affiliation: Emeritus Professor, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
authors.affiliation: Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D041881:Cholecystitis, Acute / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D015331:Cohort Studies; D000072700:Conservative Treatment / Q000379:methods; D004322:Drainage / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D038622:Internationality; D007564:Japan; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D057216:Propensity Score; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D013624:Taiwan; D016896:Treatment Outcome
keywords: Acute cholecystitis; Endoscopic gallbladder stenting; Endoscopic naso-gallbladder drainage; Gallbladder drainage; Percutaneous transhepatic gallbladder drainage