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Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy in patients with moderate acute cholecystitis under antithrombotic therapy
Author(s) -
Shibasaki Susumu,
Takahashi Norihiko,
Toi Hirofumi,
Tsuda Ichiro,
Nakamura Takahisa,
Hase Taiji,
Minagawa Nozomi,
Homma Shigenori,
Kawamura Hideki,
Taketomi Akinobu
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.28
Subject(s) - medicine , antithrombotic , percutaneous , perioperative , gallbladder , surgery , incidence (geometry) , cholecystitis , cholecystectomy , physics , optics
Background Standard treatment for acute cholecystitis ( AC ) in patients receiving antithrombotic drugs has not been established. We evaluated the safety of percutaneous transhepatic gallbladder drainage ( PTGBD ) followed by elective laparoscopic cholecystectomy ( LC ) in patients with moderate AC who were receiving antithrombotics. Methods Seventy‐five patients received PTGBD from J anuary 2006 to M arch 2013 followed by elective LC for moderate AC . Patients were divided into Group A , which consisted of patients receiving antithrombotic therapy ( n = 23), and Group B , which included the remaining patients ( n = 52). We analyzed clinical outcomes and perioperative complications between groups. Results No hemorrhagic events occurred during PTGBD insertion regardless of antithrombotic treatment. The open conversion rate was not significantly different between the two groups. Postoperative complications were found in 10 patients (13.3%). The rate of postoperative complications in Group A was slightly higher than that in Group B , but the difference was not significant (21.7% vs. 9.6%; P = 0.15). Complications associated with PTGBD occurred in six patients (8%). There were no significant differences in the incidence of these complications, operation time, intraoperative blood loss, or length of postoperative hospital stay. Conclusions Percutaneous transhepatic gallbladder drainage followed by elective LC may be an effective therapeutic strategy for moderate AC in patients receiving antithrombotic therapy.