Endoscopic ultrasound-guided versus percutaneous transhepatic gallbladder drainage in surgically high-risk patients with acute cholecystitis: a systematic review and meta-analysis.
Ricardo Antonio González-Jaramillo, Eduardo Jordan García, Andrea Melissa Briceño Gonzalez et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis compared endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) and percutaneous transhepatic gallbladder drainage (PTGBD) in surgically high-risk patients with acute cholecystitis. Among 712 patients, EUS-GBD had a lower rate of device- or drainage-related unplanned readmissions (7.0% vs 37.1%). However, the pooled analysis did not robustly support EUS-GBD as superior to PTGBD.
Key findings
- Device- or drainage-related unplanned readmission occurred in 7.0% of EUS-GBD patients compared to 37.1% of PTGBD patients.
- Technical failure was higher with EUS-GBD at 4.0% versus 1.0% for PTGBD.
- Clinical success rates and 30-day mortality did not significantly differ between the two techniques.
Why it matters
Understanding the comparative effectiveness of EUS-GBD and PTGBD is crucial for managing acute cholecystitis in high-risk surgical patients, as it informs decision-making regarding non-operative interventions.
What to keep in mind
The certainty of evidence for the primary outcome and adverse events was very low, and the pooled analysis did not robustly support the findings.