Koutlas Nicholas J, Pawa Swati, Russell Greg, Pawa Rishi
Department of Medicine, Section on Gastroenterology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
Diagnostics (Basel). 2023 Jun 1;13(11):1933. doi: 10.3390/diagnostics13111933.
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is an alternative to surgery for acute cholecystitis (AC) in poor operative candidates. However, the role of EUS-GBD in non-cholecystitis (NC) indications has not been well studied. We compared the clinical outcomes of EUS-GBD for AC and NC indications. Consecutive patients undergoing EUS-GBD for all indications at a single center were retrospectively analyzed. Fifty-one patients underwent EUS-GBD during the study period. Thirty-nine (76%) patients had AC while 12 (24%) had NC indications. NC indications included malignant biliary obstruction ( = 8), symptomatic cholelithiasis ( = 1), gallstone pancreatitis ( = 1), choledocholithiasis ( = 1), and Mirizzi's syndrome ( = 1). Technical success was noted in 92% (36/39) for AC and 92% (11/12) for NC ( > 0.99). The clinical success rate was 94% and 100%, respectively ( > 0.99). There were four adverse events in the AC group and 3 in the NC group ( = 0.33). Procedure duration (median 43 vs. 45 min, = 0.37), post-procedure length of stay (median 3 vs. 3 days, = 0.97), and total gallbladder-related procedures (median 2 vs. 2, = 0.59) were similar. EUS-GBD for NC indications is similarly safe and effective as EUS-GBD in AC.
内镜超声引导下胆囊引流术(EUS-GBD)是手术风险较高的急性胆囊炎(AC)患者的一种手术替代方案。然而,EUS-GBD在非胆囊炎(NC)适应症中的作用尚未得到充分研究。我们比较了EUS-GBD治疗AC和NC适应症的临床疗效。对在单一中心接受EUS-GBD治疗所有适应症的连续患者进行回顾性分析。在研究期间,51例患者接受了EUS-GBD治疗。39例(76%)患者为AC,12例(24%)为NC适应症。NC适应症包括恶性胆管梗阻(=8)、有症状的胆结石(=1)、胆石性胰腺炎(=1)、胆总管结石(=1)和Mirizzi综合征(=1)。AC组技术成功率为92%(36/39),NC组为92%(11/12)(P>0.99)。临床成功率分别为94%和100%(P>0.99)。AC组有4例不良事件,NC组有3例(P=0.33)。手术时间(中位数43 vs. 45分钟,P=0.37)、术后住院时间(中位数3 vs. 3天,P=0.97)和与胆囊相关的总手术次数(中位数2 vs. 2,P=0.59)相似。EUS-GBD治疗NC适应症与治疗AC一样安全有效。