Endosonography-Guided Versus Percutaneous Gallbladder Drainage Versus Cholecystectomy in Fragile Patients with Acute Cholecystitis-A High-Volume Center Study

Background and Objectives: Acute cholecystitis is a frequent cause of admission to the emergency department, especially in old and frail patients. Percutaneous drainage (PT-GBD) and endosonographic guided drainage (EUS-GBD) could be an alternative option for relieving symptoms or act as a definitive...

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Autores: Kurihara, H, Bunino, FM, Fugazza, A, Marrano, E, Mauri, G, Ceolin, M, Lanza, EZ, Colombo, M, Facciorusso, A, Repici, A, Anderloni, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p1612
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/1612
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85142646563&doi=10.3390%2fmedicina58111647&partnerID=40&md5=4300331e1f48cb51fd8db108abdc8dd5
Access Level:acceso abierto
Palabra clave:cholecystitis
percutaneous gallbladder drainage
endosonography-guided gallbladder drainage
cholecystectomy
frailty
ACS score
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spelling Endosonography-Guided Versus Percutaneous Gallbladder Drainage Versus Cholecystectomy in Fragile Patients with Acute Cholecystitis-A High-Volume Center StudyKurihara, HBunino, FMFugazza, AMarrano, EMauri, GCeolin, MLanza, EZColombo, MFacciorusso, ARepici, AAnderloni, Acholecystitispercutaneous gallbladder drainageendosonography-guided gallbladder drainagecholecystectomyfrailtyACS scoreBackground and Objectives: Acute cholecystitis is a frequent cause of admission to the emergency department, especially in old and frail patients. Percutaneous drainage (PT-GBD) and endosonographic guided drainage (EUS-GBD) could be an alternative option for relieving symptoms or act as a definitive treatment instead of a laparoscopic or open cholecystectomy (LC, OC). The aim of the present study was to compare different treatment groups. Materials and Methods: This is a five-year monocentric retrospective study including patients >= 65 years old who underwent an urgent operative procedure. A descriptive analysis was conducted comparing all treatment groups. A propensity score was estimated based on the ACS score, incorporated into a predictive model, and tested by recursive partitioning analysis. Results: 163 patients were included: 106 underwent a cholecystectomy (81 laparoscopic (LC) and 25 Open (OC)), 33 a PT-GBD and 21 EUS-GBD. The sample was categorized into three prognostic groups according to the adverse event occurrence rate. All patients treated with EUS-GBD or LC resulted in the low risk group, and the adverse event rate (AE) was 10/96 (10.4%). The AE was 4/28 (14.2%) and 21/36 (58.3%) in the middle- and high-risk groups respectively (p < 0.001). These groups included all the patients who underwent an OC or a PT-GBD. The PT-GBD group had a lower clinical success rate (55.5%) and higher RR (16,6%) when compared with other groups. Conclusions: Surgery still represents the gold standard for AC treatment. Nevertheless, EUS-GBD is a good alternative to PT-GBD in terms of clinical success, RR and AEs in all kinds of patients.MDPI2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/1612https://www.scopus.com/inward/record.uri?eid=2-s2.0-85142646563&doi=10.3390%2fmedicina58111647&partnerID=40&md5=4300331e1f48cb51fd8db108abdc8dd5Medicina-LithuaniaISSN: 1010660XISSNe: 16489144reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Lithuanianinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p16122026-06-21T15:30:37Z
dc.title.none.fl_str_mv Endosonography-Guided Versus Percutaneous Gallbladder Drainage Versus Cholecystectomy in Fragile Patients with Acute Cholecystitis-A High-Volume Center Study
title Endosonography-Guided Versus Percutaneous Gallbladder Drainage Versus Cholecystectomy in Fragile Patients with Acute Cholecystitis-A High-Volume Center Study
spellingShingle Endosonography-Guided Versus Percutaneous Gallbladder Drainage Versus Cholecystectomy in Fragile Patients with Acute Cholecystitis-A High-Volume Center Study
Kurihara, H
cholecystitis
percutaneous gallbladder drainage
endosonography-guided gallbladder drainage
cholecystectomy
frailty
ACS score
title_short Endosonography-Guided Versus Percutaneous Gallbladder Drainage Versus Cholecystectomy in Fragile Patients with Acute Cholecystitis-A High-Volume Center Study
title_full Endosonography-Guided Versus Percutaneous Gallbladder Drainage Versus Cholecystectomy in Fragile Patients with Acute Cholecystitis-A High-Volume Center Study
title_fullStr Endosonography-Guided Versus Percutaneous Gallbladder Drainage Versus Cholecystectomy in Fragile Patients with Acute Cholecystitis-A High-Volume Center Study
title_full_unstemmed Endosonography-Guided Versus Percutaneous Gallbladder Drainage Versus Cholecystectomy in Fragile Patients with Acute Cholecystitis-A High-Volume Center Study
title_sort Endosonography-Guided Versus Percutaneous Gallbladder Drainage Versus Cholecystectomy in Fragile Patients with Acute Cholecystitis-A High-Volume Center Study
dc.creator.none.fl_str_mv Kurihara, H
Bunino, FM
Fugazza, A
Marrano, E
Mauri, G
Ceolin, M
Lanza, EZ
Colombo, M
Facciorusso, A
Repici, A
Anderloni, A
author Kurihara, H
author_facet Kurihara, H
Bunino, FM
Fugazza, A
Marrano, E
Mauri, G
Ceolin, M
Lanza, EZ
Colombo, M
Facciorusso, A
Repici, A
Anderloni, A
author_role author
author2 Bunino, FM
Fugazza, A
Marrano, E
Mauri, G
Ceolin, M
Lanza, EZ
Colombo, M
Facciorusso, A
Repici, A
Anderloni, A
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv cholecystitis
percutaneous gallbladder drainage
endosonography-guided gallbladder drainage
cholecystectomy
frailty
ACS score
topic cholecystitis
percutaneous gallbladder drainage
endosonography-guided gallbladder drainage
cholecystectomy
frailty
ACS score
description Background and Objectives: Acute cholecystitis is a frequent cause of admission to the emergency department, especially in old and frail patients. Percutaneous drainage (PT-GBD) and endosonographic guided drainage (EUS-GBD) could be an alternative option for relieving symptoms or act as a definitive treatment instead of a laparoscopic or open cholecystectomy (LC, OC). The aim of the present study was to compare different treatment groups. Materials and Methods: This is a five-year monocentric retrospective study including patients >= 65 years old who underwent an urgent operative procedure. A descriptive analysis was conducted comparing all treatment groups. A propensity score was estimated based on the ACS score, incorporated into a predictive model, and tested by recursive partitioning analysis. Results: 163 patients were included: 106 underwent a cholecystectomy (81 laparoscopic (LC) and 25 Open (OC)), 33 a PT-GBD and 21 EUS-GBD. The sample was categorized into three prognostic groups according to the adverse event occurrence rate. All patients treated with EUS-GBD or LC resulted in the low risk group, and the adverse event rate (AE) was 10/96 (10.4%). The AE was 4/28 (14.2%) and 21/36 (58.3%) in the middle- and high-risk groups respectively (p < 0.001). These groups included all the patients who underwent an OC or a PT-GBD. The PT-GBD group had a lower clinical success rate (55.5%) and higher RR (16,6%) when compared with other groups. Conclusions: Surgery still represents the gold standard for AC treatment. Nevertheless, EUS-GBD is a good alternative to PT-GBD in terms of clinical success, RR and AEs in all kinds of patients.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/1612
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85142646563&doi=10.3390%2fmedicina58111647&partnerID=40&md5=4300331e1f48cb51fd8db108abdc8dd5
url https://i3pt.portalinvestigacion.com/publicaciones/1612
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85142646563&doi=10.3390%2fmedicina58111647&partnerID=40&md5=4300331e1f48cb51fd8db108abdc8dd5
dc.language.none.fl_str_mv Lithuanian
language_invalid_str_mv Lithuanian
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Medicina-Lithuania
ISSN: 1010660X
ISSNe: 16489144
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
repository.name.fl_str_mv
repository.mail.fl_str_mv
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