Endoscopic gallbladder drainage compared with percutaneous drainage

BackgroundHigh-risk patients with cholecystitis have conventionally been offered percutaneous gallbladder drainage (PGBD) for treatment. A growing experience of endoscopic gallbladder drainage (EGBD) has been reported to be effective and safe.ObjectiveTo compare the short- and long-term outcomes of EGBD and PGBD.DesignA retrospective review.SettingSingle academic tertiary care center.PatientsInpatients diagnosed with cholecystitis.InterventionsAny patient deemed a nonsurgical candidate and who has undergone either PGBD or EGBD was included in the analysis.Main Outcome MeasurementsPatient demographics along with procedural and clinical outcomes were recorded for each group.ResultsForty-three patients underwent PGBD and 30 underwent EGBD (24 transpapillary, 6 transmural). Technical (97.6% vs 100%) and clinical (97.6% vs 86.7%) success rates of PGBD and EGBD were similar. However, postprocedure hospital length of stay (16.3 vs 7.6 days), time to clinical resolution (4.6 vs 3.0 days), adverse event rate (39.5% vs 13.3%), number of sessions (2.0 vs 1.0), number of repeat interventions (53.4% vs 13.3%), and postprocedure pain scores (3.8 vs 2.1) were significantly higher for PGBD than EGBD.LimitationsRetrospective analysis.ConclusionAlthough EGBD has similar technical and clinical success compared with PGBD, it uses fewer hospital resources and results in fewer adverse events, improved pain scores, and decreased need for repeat gallbladder drainage. EGBD may provide a less-invasive, safer, cost-effective option for gallbladder drainage than PGBD with improved clinical outcomes.