Cystic Duct Embolization with Chemical Gallbladder Ablation for the Treatment of Acute Calculous Cholecystitis in High-Risk Patients: A Prospective Single-Center Study.

Autor:	Atar E; Department of Diagnostic Imaging, Interventional and Vascular Unit, Rabin Medical Center, Petah Tikva, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva 49100, Israel., Khasminsky V; Department of Diagnostic Imaging, Interventional and Vascular Unit, Rabin Medical Center, Petah Tikva, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva 49100, Israel., Friehmann T; Department of Diagnostic Imaging, Interventional and Vascular Unit, Rabin Medical Center, Petah Tikva, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva 49100, Israel., Choen A; Department of Diagnostic Imaging, Interventional and Vascular Unit, Rabin Medical Center, Petah Tikva, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva 49100, Israel., Bachar GN; Department of Diagnostic Imaging, Interventional and Vascular Unit, Rabin Medical Center, Petah Tikva, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva 49100, Israel. Electronic address: drbachar@netvision.net.il.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2020 Apr; Vol. 31 (4), pp. 644-648. Date of Electronic Publication: 2020 Mar 04.
DOI:	10.1016/j.jvir.2019.12.806
Abstrakt:	Purpose: To demonstrate the feasibility of cystic duct embolization and chemical gallbladder ablation as an alternative to cholecystectomy in high-risk patients with calculous cholecystitis who were not candidates for surgery. Materials and Methods: This prospective study included 10 patients with acute cholecystitis (7 males and 3 females) aged 70-91 years (average age, 81.6 years) between 2013 and 2019. A cholecystostomy catheter was inserted during the acute phase, followed by cystic duct coil embolization performed via the existing drainage tube tract. Once asymptomatic, 3% aethoxysklerol was injected into the gallbladder, and the drain was removed upon sonographic confirmation that the gallbladder remained contracted. Each phase of the procedure was performed with an interval of 2-3 weeks. Clinical, cholangiographic, and sonographic data were collected before and after drain removal at 1-month follow-up. Results: Cystic duct embolization was technically successful in all patients, with no immediate post-procedure complications. Gallbladder ablation performed in 10 patients was technically successful in all of them (median follow-up, 11 months). One patient required repeat ablation at 14 months, and the prolonged biliary excretions of 1 other patient ceased only at 8 months. Conclusions: Cystic duct embolization with gallbladder ablation is a feasible procedure for patients in whom cholecystectomy is contraindicated. (Copyright © 2020 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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