Ethanol Chemical Gallbladder Ablation for Cholecystitis in Inoperable Elderly Patients.

Autor: Le Tat T; Service de Radiologie Interventionnelle, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, 91100, Corbeil-Essonnes, France. letat.thomas@yahoo.fr.; Service de Radiologie Diagnostique Et Interventionnelle, Hôpital d'Instruction Des Armées Percy, 2 Rue Lieutenant Raoul Batany, 92140, Clamart, France. letat.thomas@yahoo.fr., Jost R; Service de Radiologie Interventionnelle, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, 91100, Corbeil-Essonnes, France., Hanotin C; Service de Radiologie Interventionnelle, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, 91100, Corbeil-Essonnes, France., Lucas A; Service de Radiologie Interventionnelle, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, 91100, Corbeil-Essonnes, France., Abed A; Service de Radiologie Interventionnelle, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, 91100, Corbeil-Essonnes, France., Hakime A; Service de Radiologie Interventionnelle, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, 91100, Corbeil-Essonnes, France.; Service de Radiologie Interventionnelle, American Hospital of Paris, 55 Boulevard du Château, 92200, Neuilly-Sur-Seine, France., Proske JM; Service de Chirurgie Digestive, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, 91100, Corbeil-Essonnes, France., Kuoch V; Service de Radiologie Interventionnelle, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, 91100, Corbeil-Essonnes, France.
Jazyk: angličtina
Zdroj: Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2024 Nov 27. Date of Electronic Publication: 2024 Nov 27.
DOI: 10.1007/s00270-024-03921-8
Abstrakt: Purpose: Cholecystitis presents significant treatment challenges, especially in elderly patients with high surgical or anesthetic risks. While cholecystectomy remains the standard intervention, its feasibility is sometimes limited, leading to reliance on cholecystostomy, which has a high recurrence rate and does not address the underlying cause. The aim was to evaluate the efficacy and safety of chemical gallbladder ablation as a minimally invasive treatment option for acute cholecystitis in elderly and comorbid patients.
Materials and Methods: This retrospective study included patients admitted for chemical gallbladder ablation from 2014 to 2024, contraindicated for cholecystectomy/anesthesia. Procedures involved ultrasound-guided drainage, cholangiography, potential cystic duct embolization, and ethanol ablation. Outcomes measured included complications, recurrence rates, gallbladder atrophy rates, and hospital stay duration.
Results: Of 24 patients considered, 20 underwent chemical ablation with no reported complications or ethanol intoxication, with one recurrence of cholecystitis. 9 patients underwent cystic duct embolization prior to chemical ablation. The median hospital stay duration and post-procedure overall survival was 20 and 603 days, respectively. Among the 13 patients who received follow-up imaging, gallbladder atrophy was achieved in 5 of the 6 patients who had cystic duct embolization prior to chemical ablation, and 2 of the 7 patients who had not cystic duct embolization.
Conclusion: This series suggests that chemical gallbladder ablation with cystic duct embolization could be a viable, safe and minimally invasive option for managing acute cholecystitis in elderly, multimorbid patients. Further research is necessary to validate these findings.
Competing Interests: Declarations. Conflict of interest: The authors declare that they have no conflict of interest. Ethical Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Formal Consent: For this type of study formal consent is not required (non-interventional retrospective study). Informed Consent: For this type of study informed consent is not required. Consent for Publication: For this type of study consent for publication is not required.
(© 2024. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)
Databáze: MEDLINE
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