Abstract
Acute cholecystitis (AC) is a very common disease in clinical practice. Laparoscopic
cholecystectomy remains the gold standard treatment for AC, however due to aging population,
the increased prevalence of multiple comorbidities and the extensive use of anticoagulants,
surgical procedures may be too risky when dealing with patients in emergency settings.
In these subsets of patients, a mini-invasive management may be an effective option,
both as a definitive treatment or as bridge-to-surgery. In this paper, several non-operative
treatments are described and their benefits and drawbacks are highlighted. Percutaneous
gallbladder drainage (PT-GBD) is one of the most common and widespread techniques.
It is easy to perform and has a good cost/benefit ratio. Endoscopic transpapillary
gallbladder drainage (ETGBD) is a challenging procedure that is usually performed
in high volume centers by expert endoscopists, and it has a specific indication for
selected cases. EUS-guided drainage (EUS-GBD) is still not widely available, but it
is an effective procedure that could have several advantages, especially in rate of
reinterventions. All these treatment options should be considered together in a stepwise
approach and addressed to patients after an accurate case-by-case evaluation in a
multidisciplinary discussion. In this review, we provide a possible flowchart in order
to optimize treatments, resource and provide to patients a tailored approach.
Keywords
Abbreviations:
EUS-GBD (endoscopic ultrasound gallbladder drainage), PT-GBD (percutaneous gallbladder drainage), ET-GBD (endoscopic transpapillary gallbladder drainage)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 06, 2023
Accepted:
February 6,
2023
Received:
October 1,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
