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Management of acute cholecystitis after biliary stenting for malignant obstruction: comparison of percutaneous gallbladder drainage and aspiration

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Abstract

Purpose

To evaluate and compare the clinical outcomes between percutaneous gallbladder drainage (PGBD) and percutaneous gallbladder aspiration (PGBA) for acute cholecystitis after biliary stenting for malignant biliary obstruction.

Materials and methods

Twenty-six and 14 patients underwent PGBD and PGBA, respectively, for acute cholecystitis after biliary stenting for malignant obstruction. The technical success rate, clinical effectiveness, and safety were compared between the 2 groups.

Results

Technical success was achieved in all patients. Clinical effectiveness rate was significantly higher in the PGBD group than in the PGBA group [100% (26/26) vs. 57% (8/14), p < 0.01]. In the PGBA group, clinical effectiveness rate was significantly lower in patients with tumor involvement of the cystic duct [13% (1/8) with involvement vs. 83% (5/6) without involvement, p = 0.03]. There were no deaths related to the procedure or acute cholecystitis aggravation. Pleural effusion and biliary peritonitis occurred in 1 patient each after PGBD and intra-abdominal bleeding occurred in 1 patient after PGBA as complications requiring treatment.

Conclusion

Although PGBD was a more effective treatment for acute cholecystitis after biliary stenting for malignant obstruction, PGBA may be a less invasive option for high-risk patients without tumor involvement of the cystic duct.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Aichi, Japan

    Yugo Imai, Takaaki Hasegawa, Yozo Sato, Hidekazu Yamaura, Shinichi Murata, Mina Kato & Yoshitaka Inaba

  2. Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

    Kazuo Hara

  3. Departments of Radiology, Shiga University of Medical Science, Otsu, Japan

    Norihisa Nitta

Authors
  1. Yugo Imai
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  2. Takaaki Hasegawa
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  3. Yozo Sato
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  4. Hidekazu Yamaura
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  5. Shinichi Murata
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  6. Mina Kato
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  7. Kazuo Hara
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  8. Norihisa Nitta
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  9. Yoshitaka Inaba
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Corresponding author

Correspondence to Yugo Imai.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

This retrospective study was approved by our institutional review board and the necessity of informed consent for inclusion in this study was waived. Informed consent to perform PGBD or PGBA was obtained from all patients before the procedure.

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Imai, Y., Hasegawa, T., Sato, Y. et al. Management of acute cholecystitis after biliary stenting for malignant obstruction: comparison of percutaneous gallbladder drainage and aspiration. Jpn J Radiol 37, 719–726 (2019). https://doi.org/10.1007/s11604-019-00865-9

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  • DOI: https://doi.org/10.1007/s11604-019-00865-9

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