Efficacy and safety of endoscopic gallbladder drainage in acute cholecystitis: Is it better than percutaneous gallbladder drainage?

Muhammad Ali Khan, Omair Atiq, Nisa Kubiliun, Bilal Ali, Faisal Kamal, Richard Nollan, Mohammad Kashif Ismail, Claudio Tombazzi, Michel Kahaleh, Todd H. Baron

Research output: Contribution to journalReview article

32 Citations (Scopus)

Abstract

Background and Aims The efficacy and safety of endoscopic gallbladder drainage (EGBD) performed via endoscopic retrograde cholangiography (ERC)-based transpapillary stenting or EUS-based transmural stenting are unknown. We aimed to conduct a proportion meta-analysis to evaluate the cumulative efficacy and safety of these procedures and to compare them with percutaneous gallbladder drainage (PGBD). Methods We searched several databases from inception through December 10, 2015 to identify studies (with 10 or more patients) reporting technical success and postprocedure adverse events of EGBD. Weighted pooled rates (WPRs) for technical and clinical success, postprocedure adverse events, and recurrent cholecystitis were calculated for both methods of EGBD. Pooled odds ratios (ORs) were also calculated to compare the technical success and postprocedure adverse events in patients undergoing EGBD versus PGBD. Results The WPRs with 95% confidence intervals (CIs) of technical success, clinical success, postprocedure adverse events, and recurrent cholecystitis for ERC-based transpapillary drainage were 83% (95% CI, 78%-87%; I2 = 38%), 93% (95% CI, 89%-96%; I2 = 39%), 10% (95% CI, 7%-13%; I2 = 27%), and 3% (95% CI, 1%-5%; I2 = 0%), respectively. The WPRs for EUS-based drainage for technical success, clinical success, postprocedure adverse events, and recurrent cholecystitis were 93% (95% CI, 87%-96%; I2 = 0%), 97% (95% CI, 93%-99%; I2 = 0%), 13% (95% CI, 8%-19%; I2 = 0%), and 4% (95% CI, 2%-9%; I2 = 0%), respectively. On proportionate difference, EUS-based drainage had better technical (10%) and clinical success (4%) in comparison with ERC-based drainage. The pooled OR for technical success of EGBD versus PGBD was. 51 (95% CI,. 09-2.88; I2 = 23%) and for postprocedure adverse events was. 33 (95% CI,. 14-.80; I2 = 16%) in favor of EGBD. Conclusions EGBD is an efficacious and safe therapeutic modality for treatment of patients with acute cholecystitis who cannot undergo surgery. EGBD shows a similar technical success as PGBD but appears to be safer than PGBD.

Original languageEnglish (US)
Pages (from-to)76-87.e3
JournalGastrointestinal Endoscopy
Volume85
Issue number1
DOIs
StatePublished - Jan 1 2017

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Acute Cholecystitis
Gallbladder
Drainage
Safety
Confidence Intervals
Cholecystitis
Cholangiography
Odds Ratio

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Efficacy and safety of endoscopic gallbladder drainage in acute cholecystitis : Is it better than percutaneous gallbladder drainage? / Khan, Muhammad Ali; Atiq, Omair; Kubiliun, Nisa; Ali, Bilal; Kamal, Faisal; Nollan, Richard; Ismail, Mohammad Kashif; Tombazzi, Claudio; Kahaleh, Michel; Baron, Todd H.

In: Gastrointestinal Endoscopy, Vol. 85, No. 1, 01.01.2017, p. 76-87.e3.

Research output: Contribution to journalReview article

Khan, Muhammad Ali ; Atiq, Omair ; Kubiliun, Nisa ; Ali, Bilal ; Kamal, Faisal ; Nollan, Richard ; Ismail, Mohammad Kashif ; Tombazzi, Claudio ; Kahaleh, Michel ; Baron, Todd H. / Efficacy and safety of endoscopic gallbladder drainage in acute cholecystitis : Is it better than percutaneous gallbladder drainage?. In: Gastrointestinal Endoscopy. 2017 ; Vol. 85, No. 1. pp. 76-87.e3.
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abstract = "Background and Aims The efficacy and safety of endoscopic gallbladder drainage (EGBD) performed via endoscopic retrograde cholangiography (ERC)-based transpapillary stenting or EUS-based transmural stenting are unknown. We aimed to conduct a proportion meta-analysis to evaluate the cumulative efficacy and safety of these procedures and to compare them with percutaneous gallbladder drainage (PGBD). Methods We searched several databases from inception through December 10, 2015 to identify studies (with 10 or more patients) reporting technical success and postprocedure adverse events of EGBD. Weighted pooled rates (WPRs) for technical and clinical success, postprocedure adverse events, and recurrent cholecystitis were calculated for both methods of EGBD. Pooled odds ratios (ORs) were also calculated to compare the technical success and postprocedure adverse events in patients undergoing EGBD versus PGBD. Results The WPRs with 95{\%} confidence intervals (CIs) of technical success, clinical success, postprocedure adverse events, and recurrent cholecystitis for ERC-based transpapillary drainage were 83{\%} (95{\%} CI, 78{\%}-87{\%}; I2 = 38{\%}), 93{\%} (95{\%} CI, 89{\%}-96{\%}; I2 = 39{\%}), 10{\%} (95{\%} CI, 7{\%}-13{\%}; I2 = 27{\%}), and 3{\%} (95{\%} CI, 1{\%}-5{\%}; I2 = 0{\%}), respectively. The WPRs for EUS-based drainage for technical success, clinical success, postprocedure adverse events, and recurrent cholecystitis were 93{\%} (95{\%} CI, 87{\%}-96{\%}; I2 = 0{\%}), 97{\%} (95{\%} CI, 93{\%}-99{\%}; I2 = 0{\%}), 13{\%} (95{\%} CI, 8{\%}-19{\%}; I2 = 0{\%}), and 4{\%} (95{\%} CI, 2{\%}-9{\%}; I2 = 0{\%}), respectively. On proportionate difference, EUS-based drainage had better technical (10{\%}) and clinical success (4{\%}) in comparison with ERC-based drainage. The pooled OR for technical success of EGBD versus PGBD was. 51 (95{\%} CI,. 09-2.88; I2 = 23{\%}) and for postprocedure adverse events was. 33 (95{\%} CI,. 14-.80; I2 = 16{\%}) in favor of EGBD. Conclusions EGBD is an efficacious and safe therapeutic modality for treatment of patients with acute cholecystitis who cannot undergo surgery. EGBD shows a similar technical success as PGBD but appears to be safer than PGBD.",
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T1 - Efficacy and safety of endoscopic gallbladder drainage in acute cholecystitis

T2 - Is it better than percutaneous gallbladder drainage?

AU - Khan, Muhammad Ali

AU - Atiq, Omair

AU - Kubiliun, Nisa

AU - Ali, Bilal

AU - Kamal, Faisal

AU - Nollan, Richard

AU - Ismail, Mohammad Kashif

AU - Tombazzi, Claudio

AU - Kahaleh, Michel

AU - Baron, Todd H.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background and Aims The efficacy and safety of endoscopic gallbladder drainage (EGBD) performed via endoscopic retrograde cholangiography (ERC)-based transpapillary stenting or EUS-based transmural stenting are unknown. We aimed to conduct a proportion meta-analysis to evaluate the cumulative efficacy and safety of these procedures and to compare them with percutaneous gallbladder drainage (PGBD). Methods We searched several databases from inception through December 10, 2015 to identify studies (with 10 or more patients) reporting technical success and postprocedure adverse events of EGBD. Weighted pooled rates (WPRs) for technical and clinical success, postprocedure adverse events, and recurrent cholecystitis were calculated for both methods of EGBD. Pooled odds ratios (ORs) were also calculated to compare the technical success and postprocedure adverse events in patients undergoing EGBD versus PGBD. Results The WPRs with 95% confidence intervals (CIs) of technical success, clinical success, postprocedure adverse events, and recurrent cholecystitis for ERC-based transpapillary drainage were 83% (95% CI, 78%-87%; I2 = 38%), 93% (95% CI, 89%-96%; I2 = 39%), 10% (95% CI, 7%-13%; I2 = 27%), and 3% (95% CI, 1%-5%; I2 = 0%), respectively. The WPRs for EUS-based drainage for technical success, clinical success, postprocedure adverse events, and recurrent cholecystitis were 93% (95% CI, 87%-96%; I2 = 0%), 97% (95% CI, 93%-99%; I2 = 0%), 13% (95% CI, 8%-19%; I2 = 0%), and 4% (95% CI, 2%-9%; I2 = 0%), respectively. On proportionate difference, EUS-based drainage had better technical (10%) and clinical success (4%) in comparison with ERC-based drainage. The pooled OR for technical success of EGBD versus PGBD was. 51 (95% CI,. 09-2.88; I2 = 23%) and for postprocedure adverse events was. 33 (95% CI,. 14-.80; I2 = 16%) in favor of EGBD. Conclusions EGBD is an efficacious and safe therapeutic modality for treatment of patients with acute cholecystitis who cannot undergo surgery. EGBD shows a similar technical success as PGBD but appears to be safer than PGBD.

AB - Background and Aims The efficacy and safety of endoscopic gallbladder drainage (EGBD) performed via endoscopic retrograde cholangiography (ERC)-based transpapillary stenting or EUS-based transmural stenting are unknown. We aimed to conduct a proportion meta-analysis to evaluate the cumulative efficacy and safety of these procedures and to compare them with percutaneous gallbladder drainage (PGBD). Methods We searched several databases from inception through December 10, 2015 to identify studies (with 10 or more patients) reporting technical success and postprocedure adverse events of EGBD. Weighted pooled rates (WPRs) for technical and clinical success, postprocedure adverse events, and recurrent cholecystitis were calculated for both methods of EGBD. Pooled odds ratios (ORs) were also calculated to compare the technical success and postprocedure adverse events in patients undergoing EGBD versus PGBD. Results The WPRs with 95% confidence intervals (CIs) of technical success, clinical success, postprocedure adverse events, and recurrent cholecystitis for ERC-based transpapillary drainage were 83% (95% CI, 78%-87%; I2 = 38%), 93% (95% CI, 89%-96%; I2 = 39%), 10% (95% CI, 7%-13%; I2 = 27%), and 3% (95% CI, 1%-5%; I2 = 0%), respectively. The WPRs for EUS-based drainage for technical success, clinical success, postprocedure adverse events, and recurrent cholecystitis were 93% (95% CI, 87%-96%; I2 = 0%), 97% (95% CI, 93%-99%; I2 = 0%), 13% (95% CI, 8%-19%; I2 = 0%), and 4% (95% CI, 2%-9%; I2 = 0%), respectively. On proportionate difference, EUS-based drainage had better technical (10%) and clinical success (4%) in comparison with ERC-based drainage. The pooled OR for technical success of EGBD versus PGBD was. 51 (95% CI,. 09-2.88; I2 = 23%) and for postprocedure adverse events was. 33 (95% CI,. 14-.80; I2 = 16%) in favor of EGBD. Conclusions EGBD is an efficacious and safe therapeutic modality for treatment of patients with acute cholecystitis who cannot undergo surgery. EGBD shows a similar technical success as PGBD but appears to be safer than PGBD.

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