Amy Tyberg1, Monica Saumoy1, Enrique V Sequeiros2,3, Marc Giovannini4, Everson Artifon5, Anthony Teoh6, Jose Nieto7, Amit P Desai1, Nikhil A Kumta1, Monica Gaidhane1, Reem Z Sharaiha1, Michel Kahaleh1. 1. Division of Gastroenterology & Hepatology, Weill Cornell Medical College, New York, NY. 2. Endoscopy Unit, Gastroenterology Division, University Hospital Ramón y Cajal, IRYCIS. 3. Gastroenterology Division, University Hospital Quirón, Madrid, Spain. 4. Department of Gastroenterology and Endoscopy, Paoli-Calmettes Institute, Marseille, France. 5. GI Endoscopy Unit, Department of Surgery, Ana Costa Hospital, Santos, Brazil. 6. Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong. 7. Borland-Groover Clinic, Jacksonville, FL.
Abstract
BACKGROUND AND AIMS: Endoscopic ultrasound-guided drainage (EUS-GLB) is a minimally invasive option for patients with cholecystitis who are poor surgical candidates. Compared with percutaneous drainage (PC-GLB), earlier studies have demonstrated similar efficacy with improved quality of life. We present a multicenter, international experience comparing PC-GLB and EUS-GLB in nonsurgical patients with cholecystitis. METHODS: All patients who underwent either PC-GLB drainage or EUS-GLB drainage from 7 centers between January 2010 and December 2015 were included. Technical success was defined as successful placement of a catheter or stent into the gallbladder. Clinical success was defined as resolution of clinical symptoms after intervention. Adverse events, length of stay, and the need for repeat interventions and/or hospitalizations were recorded for all patients. RESULTS: A total of 155 patients were included (mean age 74±14.24 y; range, 31 to 96; 56% male). Forty-two patients underwent EUS-GLB and 113 patients underwent PC-GLB. Technical success was achieved in 40 patients (95%) in the EUS-GLB group and 112 patients (99%) in the PC-GLB group (P=0.179). Clinical success was achieved in 40 patients (95%) in the EUS-GLB group and 97 patients (86%) in the PC-GLB group (P=0.157). There was no difference in hospital readmission rates between the 2 groups (14% vs. 24%; P=0.194). However, there was significantly higher number of patients requiring repeat interventions in the PC-GLB group (n=28, 24%) compared with the EUS-GLB group (n=4, 10%) (P=0.037). There was no difference in adverse events between the 2 groups. CONCLUSIONS: EUS-GLB is safe and efficacious, with comparable technical and clinical success rates and no difference in adverse events. In addition, EUS-GLB offers a potential cost-saving benefit and morbidity benefit by demonstrating a decreased number of repeat interventions.
BACKGROUND AND AIMS: Endoscopic ultrasound-guided drainage (EUS-GLB) is a minimally invasive option for patients with cholecystitis who are poor surgical candidates. Compared with percutaneous drainage (PC-GLB), earlier studies have demonstrated similar efficacy with improved quality of life. We present a multicenter, international experience comparing PC-GLB and EUS-GLB in nonsurgical patients with cholecystitis. METHODS: All patients who underwent either PC-GLB drainage or EUS-GLB drainage from 7 centers between January 2010 and December 2015 were included. Technical success was defined as successful placement of a catheter or stent into the gallbladder. Clinical success was defined as resolution of clinical symptoms after intervention. Adverse events, length of stay, and the need for repeat interventions and/or hospitalizations were recorded for all patients. RESULTS: A total of 155 patients were included (mean age 74±14.24 y; range, 31 to 96; 56% male). Forty-two patients underwent EUS-GLB and 113 patients underwent PC-GLB. Technical success was achieved in 40 patients (95%) in the EUS-GLB group and 112 patients (99%) in the PC-GLB group (P=0.179). Clinical success was achieved in 40 patients (95%) in the EUS-GLB group and 97 patients (86%) in the PC-GLB group (P=0.157). There was no difference in hospital readmission rates between the 2 groups (14% vs. 24%; P=0.194). However, there was significantly higher number of patients requiring repeat interventions in the PC-GLB group (n=28, 24%) compared with the EUS-GLB group (n=4, 10%) (P=0.037). There was no difference in adverse events between the 2 groups. CONCLUSIONS:EUS-GLB is safe and efficacious, with comparable technical and clinical success rates and no difference in adverse events. In addition, EUS-GLB offers a potential cost-saving benefit and morbidity benefit by demonstrating a decreased number of repeat interventions.
Authors: Ola Ahmed; Ailin C Rogers; Jarlath C Bolger; Achille Mastrosimone; Michael J Lee; Aoife N Keeling; Daniel Cheriyan; William B Robb Journal: Surg Endosc Date: 2018-02-05 Impact factor: 4.584
Authors: Ali Siddiqui; Rastislav Kunda; Amy Tyberg; Mustafa A Arain; Arish Noor; Tayebah Mumtaz; Usama Iqbal; David E Loren; Thomas E Kowalski; Douglas G Adler; Monica Saumoy; Monica Gaidhane; Shawn Mallery; Eric M Christiansen; Jose Nieto; Michel Kahaleh Journal: Surg Endosc Date: 2018-09-12 Impact factor: 4.584