Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2020; 26(36): 5498-5507
Published online Sep 28, 2020. doi: 10.3748/wjg.v26.i36.5498
Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy
Peng Liu, Che Liu, Yin-Tao Wu, Jian-Yong Zhu, Wen-Chao Zhao, Jing-Bo Li, Hong Zhang, Ying-Xiang Yang
Peng Liu, Che Liu, Yin-Tao Wu, Jian-Yong Zhu, Wen-Chao Zhao, Jing-Bo Li, Hong Zhang, Ying-Xiang Yang, Department of Hepatobiliary Surgery, The Sixth Medical Center of People’s Liberation Army General Hospital, Beijing 100048, China
Author contributions: Liu P performed percutaneous cholecystostomy and laparoscopic cholecystostomy, collected the data, performed the statistical analysis and drafted the manuscript; Yang YX designed the study and revised the manuscript; Liu C, Wu YT, Zhu JY, Zhao WC, Li JB and Zhang H performed percutaneous cholecystostomy and laparoscopic cholecystostomy, collected the data and coordinated the work; All authors read and approved the final paper.
Institutional review board statement: The study was approved by the Ethics Committee of The Sixth Medical Center of People’s Liberation Army General Hospital.
Conflict-of-interest statement: The authors have no conflicts of interest or financial ties to disclose.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
STROBE statement: The guidelines of the STROBE Statement have been adopted.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ying-Xiang Yang, MD, Associate Chief Physician, Surgeon, Department of Hepatobiliary Surgery, The Sixth Medical Center of People’s Liberation Army General Hospital, No. 6 Fucheng Road, Beijing 100048, China. yangyx_pla@163.com
Received: June 10, 2020
Peer-review started: June 10, 2020
First decision: July 25, 2020
Revised: August 25, 2020
Accepted: September 1, 2020
Article in press: September 1, 2020
Published online: September 28, 2020
Processing time: 105 Days and 15.5 Hours
Abstract
BACKGROUND

B-mode-ultrasound-guided percutaneous cholecystostomy (PC) may be performed by a transhepatic or transperitoneal approach, called percutaneous transhepatic gallbladder drainage (PHGD) and percutaneous transperitoneal gallbladder drainage (PPGD), respectively. We compared the impact of PC related to the route of catheter placement on subsequent laparoscopic cholecystectomy (LC).

AIM

To compare the impact of PC related to the route of catheter placement on subsequent LC.

METHODS

We retrospectively studied 103 patients with acute calculous cholecystitis who underwent scheduled LC after PC between January 2010 and January 2019. Group I included 58 patients who underwent scheduled LC after PHGD. Group II included 45 patients who underwent scheduled LC after PPGD. Clinical outcomes were analyzed according to each group.

RESULTS

Baseline demographic characteristics did not differ significantly between both groups (P > 0.05). Both PHGD and PPGD were able to quickly resolve cholecystitis sepsis. Group I showed significantly higher efficacy than group II in terms of lower pain score during puncture (3.1 vs 4.5; P = 0.001) and at 12 h follow-up (1.5 vs 2.2; P = 0.001), lower rate of fever within 24 h after PC (13.8% vs 42.2%; P = 0.001), shorted operation duration (118.3 vs 139.6 min; P = 0.001), lower amount of intraoperative bleeding (72.1 vs 109.4 mL; P = 0.001) and shorter length of hospital stay (14.3 d vs 18.0 d; P = 0.001). However, group II had significantly lower rate of local bleeding at the PC site (2.2% vs 20.7%; P = 0.005) and lower rate of severe adhesion (33.5% vs 55.2%; P = 0.048). No significant differences were noted between both groups regarding the conversion rate to laparotomy, rate of subtotal cholecystectomy, complications and pathology.

CONCLUSION

B-mode-ultrasound-guided PHGD is superior to PPGD followed by LC for treatment of acute calculous cholecystitis, with shorter operating time, minimal amount of intraoperative bleeding and short length of hospital stay.

Keywords: Acute calculous cholecystitis; Percutaneous transhepatic gallbladder drainage; Percutaneous transperitoneal gallbladder drainage; Laparoscopic cholecystectomy; B-mode ultrasound; Acute cholecystitis

Core Tip: B-mode-ultrasound-guided percutaneous cholecystostomy (PC) may be performed by a transhepatic or transperitoneal approach, called percutaneous transhepatic gallbladder drainage (PHGD) and percutaneous transperitoneal gallbladder drainage (PPGD), respectively. However, few studies have reported the effects of the two different approaches on laparoscopic cholecystectomy (LC). We compared the impact of PC related to route of catheter placement on subsequent LC. Our results suggested that B-mode-ultrasound-guided PHGD is superior to PPGD followed by LC for treatment of acute cholecystitis (AC). We suggest that PHGD should be chosen in the early stage of AC.