Endoscopic transpapillary gallbladder stenting vs percutaneous cholecystostomy for managing acute cholecystitis: Nationwide propensity score study.

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Tác giả: Azizullah Beran, Yuting Huang, John Morris, Chun-Wei Pan, Daryl Ramai, Yichen Wang

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: Germany : Endoscopy international open , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 727919

 BACKGROUND AND STUDY AIMS: Cholecystectomy is the standard treatment for acute cholecystitis, but it may not be suitable for all patients. For those who cannot undergo surgery, a percutaneous cholecystostomy tube (PCT) and ERCP-guided transpapillary gallbladder drainage are viable options. We aimed to perform a nationwide study to assess 30-day readmission rates, adverse events (AEs), and mortality rates in these two cohorts. PATIENTS AND METHODS: We conducted a nationwide cohort study using data from the Nationwide Readmissions Database (NRD) from 2016 to 2019. We identified patients with acute cholecystitis during the index admission who underwent either PCT or ERCP-guided gallbladder drainage. Propensity score matching along with multivariable regression was used to compare cohorts. RESULTS: During the study period, 3,592 patients (average age 63.0 years) underwent endoscopic drainage, whereas 80,372 patients (average 70.8 years) underwent Interventional Radiology drainage. Utilizing multivariate Cox regression analysis, compared with ERCP, PCT had a higher risk for 30-day readmission (adjusted hazard ratio [aHR] 1.47
  95% confidence interval [CI] 1.27 to 1.71
  CONCLUSIONS: Our nationwide analysis revealed that ERCP-guided gallbladder drainage should be the preferred approach for managing acute cholecystitis when unfit for surgery.
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