Premium
Endoscopic transpapillary gallbladder drainage (ETGBD) for the treatment of acute cholecystitis
Author(s) -
Nakatsu Toshiaki,
Okada Hiroshi,
Saito Kunio,
Uchida Naohito,
Minami Atsushi,
Ezaki Toru,
Morshed Syed Ahmed,
Nishioka Mikio
Publication year - 1997
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf01211341
Subject(s) - medicine , gallbladder , percutaneous , cholecystitis , acute cholecystitis , coagulopathy , drainage , white blood cell , surgery , ecology , biology
Abstract We performed endoscopic transpapillary gallbladder drainage (ETGBD) in 21 patients with acute cholecystitis, utilizing a guidewire coated with a hydrophilic polymer. Endoscopic sphincterotomy was not performed. The clinical efficacy of ETGBD was evaluated in terms of reduction of white blood cell count (WBC) and C‐reactive protein (CRP) level. ETGBD was successful in 17 (81%) of the 21 patients, in terms of early disappearance of clinical symptoms, and significant decrease of both WBC and CRP after ETGBD ( P < 0.001). In patients with the Mirizzi syndrome ( n =2), accurate diagnosis was made by endoscopic retrograde cholangiography (ERC), facilitating proper drainage (ETGBD) immediately afterward. With ETGBD, emergency operation was avoided even in critically ill patients complicated with disseminated intravascular coagulopathy ( n =2). There were no significant complications. ETGBD may be an effective and safe alternative to percutaneous transhepatic gallbladder drainage in the management of acute cholecystitis, and may be more suitable for patients with a strong bleeding tendency.