PMID- 36289089
OWN - NLM
STAT- MEDLINE
DCOM- 20230411
LR  - 20230412
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 37
IP  - 4
DP  - 2023 Apr
TI  - Endoscopic ultrasound (EUS)-guided cholecystostomy versus percutaneous 
      cholecystostomy (PTC) in the management of acute cholecystitis in patients unfit 
      for surgery: a systematic review and meta-analysis.
PG  - 2421-2438
LID - 10.1007/s00464-022-09712-x [doi]
AB  - BACKGROUND AND AIM: Surgical cholecystectomy is the gold standard strategy for 
      the management of acute cholecystitis (AC). However, some patients are considered 
      unfit for surgery due to certain comorbid conditions. As such, we aimed to 
      compare less invasive treatment strategies such as endoscopic ultrasound-guided 
      gallbladder drainage (EUS-GBD) and percutaneous gallbladder drainage (PT-GBD) for 
      the management of patients with AC who are suboptimal candidates for surgical 
      cholecystectomy. METHODS: A comprehensive search of multiple electronic databases 
      was performed to identify all the studies comparing EUS-GBD versus PT-GBD for 
      patients with AC who were unfit for surgery. A subgroup analysis was also 
      performed for comparison of the group undergoing drainage via cautery-enhanced 
      lumen-apposing metal stents (LAMS) versus PT-GBD. The outcomes included technical 
      and clinical success, adverse events (AEs), recurrent cholecystitis, 
      reintervention, and hospital readmission. RESULTS: Eleven studies including 1155 
      patients were included in the statistical analysis. There was no difference 
      between PT-GBD and EUS-GBD in all the evaluated outcomes. On the subgroup 
      analysis, the endoscopic approach with cautery-enhanced LAMS was associated with 
      lower rates of adverse events (RD =  - 0.33 (95% CI - 0.52 to - 0.14; 
      p = 0.0006), recurrent cholecystitis (- 0.05 RD (95% CI - 0.09 to - 0.02; 
      p = 0.02), and hospital readmission (- 0.36 RD (95% CI-0.70 to - 0.03; p = 0.03) 
      when compared to PT-GBD. All other outcomes were similar in the subgroup 
      analyses. CONCLUSIONS: EUS-GBD using cautery-enhanced LAMS is superior to PT-GBD 
      in terms of safety profile, recurrent cholecystitis, and hospital readmission 
      rates in the management of patients with acute cholecystitis who are suboptimal 
      candidates for cholecystectomy. However, when cautery-enhanced LAMS are not used, 
      the outcomes of EUS-GBD and PT-GBD are similar. Thus, EUS-GBD with 
      cautery-enhanced LAMS should be considered the preferable approach for 
      gallbladder drainage for this challenging population.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Hemerly, Matheus Candido
AU  - Hemerly MC
AD  - Departamento de Gastroenterologia, Faculdade de Medicina, Servico de Endoscopia 
      Gastrointestinal Do Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. 
      Dr. Eneas de Carvalho Aguiar, 255 - Instituto Central - Predio Dos Ambulatorios, 
      Cerqueira Cesar, Sao Paulo, SP, CEP: 05403-000, Brazil.
FAU - de Moura, Diogo Turiani Hourneaux
AU  - de Moura DTH
AD  - Departamento de Gastroenterologia, Faculdade de Medicina, Servico de Endoscopia 
      Gastrointestinal Do Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. 
      Dr. Eneas de Carvalho Aguiar, 255 - Instituto Central - Predio Dos Ambulatorios, 
      Cerqueira Cesar, Sao Paulo, SP, CEP: 05403-000, Brazil.
FAU - do Monte Junior, Epifanio Silvino
AU  - do Monte Junior ES
AD  - Departamento de Gastroenterologia, Faculdade de Medicina, Servico de Endoscopia 
      Gastrointestinal Do Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. 
      Dr. Eneas de Carvalho Aguiar, 255 - Instituto Central - Predio Dos Ambulatorios, 
      Cerqueira Cesar, Sao Paulo, SP, CEP: 05403-000, Brazil.
FAU - Proenca, Igor Mendonca
AU  - Proenca IM
AD  - Departamento de Gastroenterologia, Faculdade de Medicina, Servico de Endoscopia 
      Gastrointestinal Do Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. 
      Dr. Eneas de Carvalho Aguiar, 255 - Instituto Central - Predio Dos Ambulatorios, 
      Cerqueira Cesar, Sao Paulo, SP, CEP: 05403-000, Brazil.
FAU - Ribeiro, Igor Braga
AU  - Ribeiro IB
AUID- ORCID: 0000-0003-1844-8973
AD  - Departamento de Gastroenterologia, Faculdade de Medicina, Servico de Endoscopia 
      Gastrointestinal Do Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. 
      Dr. Eneas de Carvalho Aguiar, 255 - Instituto Central - Predio Dos Ambulatorios, 
      Cerqueira Cesar, Sao Paulo, SP, CEP: 05403-000, Brazil. igorbraga1@gmail.com.
FAU - Yvamoto, Erika Yuki
AU  - Yvamoto EY
AD  - Departamento de Gastroenterologia, Faculdade de Medicina, Servico de Endoscopia 
      Gastrointestinal Do Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. 
      Dr. Eneas de Carvalho Aguiar, 255 - Instituto Central - Predio Dos Ambulatorios, 
      Cerqueira Cesar, Sao Paulo, SP, CEP: 05403-000, Brazil.
FAU - Ribas, Pedro Henrique Boraschi Vieira
AU  - Ribas PHBV
AD  - Departamento de Gastroenterologia, Faculdade de Medicina, Servico de Endoscopia 
      Gastrointestinal Do Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. 
      Dr. Eneas de Carvalho Aguiar, 255 - Instituto Central - Predio Dos Ambulatorios, 
      Cerqueira Cesar, Sao Paulo, SP, CEP: 05403-000, Brazil.
FAU - Sanchez-Luna, Sergio A
AU  - Sanchez-Luna SA
AD  - Department of Internal Medicine, Division of Gastroenterology & Hepatology, Basil 
      I. Hirschowitz Endoscopic Center of Excellence, The University of Alabama at 
      Birmingham Heersink School of Medicine, Birmingham, AL, USA.
FAU - Bernardo, Wanderley Marques
AU  - Bernardo WM
AD  - Departamento de Gastroenterologia, Faculdade de Medicina, Servico de Endoscopia 
      Gastrointestinal Do Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. 
      Dr. Eneas de Carvalho Aguiar, 255 - Instituto Central - Predio Dos Ambulatorios, 
      Cerqueira Cesar, Sao Paulo, SP, CEP: 05403-000, Brazil.
FAU - de Moura, Eduardo Guimaraes Hourneaux
AU  - de Moura EGH
AD  - Departamento de Gastroenterologia, Faculdade de Medicina, Servico de Endoscopia 
      Gastrointestinal Do Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. 
      Dr. Eneas de Carvalho Aguiar, 255 - Instituto Central - Predio Dos Ambulatorios, 
      Cerqueira Cesar, Sao Paulo, SP, CEP: 05403-000, Brazil.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20221026
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
MH  - Humans
MH  - *Cholecystostomy/adverse effects
MH  - *Cholecystitis, Acute/diagnostic imaging/surgery/etiology
MH  - Endosonography
MH  - *Cholecystitis/surgery
OTO - NOTNLM
OT  - Biliary
OT  - Cholecystectomy
OT  - Cholecystitis
OT  - Endoscopic ultrasound
OT  - Endoscopy
OT  - Fully covered self-expanding metal stents (FCSEMS)
OT  - Gallbladder
OT  - Interventional radiology
OT  - Lumen-apposing metal stents (LAMS)
OT  - Surgery
EDAT- 2022/10/27 06:00
MHDA- 2023/04/11 06:42
CRDT- 2022/10/26 23:13
PHST- 2022/03/02 00:00 [received]
PHST- 2022/10/11 00:00 [accepted]
PHST- 2023/04/11 06:42 [medline]
PHST- 2022/10/27 06:00 [pubmed]
PHST- 2022/10/26 23:13 [entrez]
AID - 10.1007/s00464-022-09712-x [pii]
AID - 10.1007/s00464-022-09712-x [doi]
PST - ppublish
SO  - Surg Endosc. 2023 Apr;37(4):2421-2438. doi: 10.1007/s00464-022-09712-x. Epub 2022 
      Oct 26.