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Medline ® Abstract for Reference 9

of 'Therapeutic endoscopic ultrasound'

EUS-guided transmural cholecystostomy as rescue management for acute cholecystitis in elderly or high-risk patients: a prospective feasibility study.
Lee SS, Park DH, Hwang CY, Ahn CS, Lee TY, Seo DW, Lee SK, Kim MW
Gastrointest Endosc. 2007;66(5):1008.
BACKGROUND: Although EUS-guided drainage procedures have been used to collect peripancreatic fluids, little is known regarding EUS-guided transmural gallbladder drainage for high-risk patients with acute cholecystitis.
OBJECTIVE: Our purpose was to evaluate the technical feasibility and outcomes of EUS-guided transmural cholecystostomy as rescue management in elderly and high-risk patients with acute cholecystitis.
DESIGN: Single-center prospective study.
SETTING: Tertiary referral center.
PATIENTS: Nine elderly or high-risk patients diagnosed with acute cholecystitis.
INTERVENTIONS: All inflamed gallbladders were drained by EUS-guided transmural cholecystostomy.
MAIN OUTCOME MEASUREMENT: Clinical resolution of acute cholecystitis.
RESULTS: After the drainage procedures, there were no immediate complications such as bleeding, bile leak, or peritonitis, except for 1 patient who had pneumoperitoneum. After EUS-guided transmural cholecystostomy, all patients showed rapid clinical improvement within 72 hours.
LIMITATIONS: Small number of patients.
CONCLUSION: EUS-guided transmural cholecystostomy may be feasible and safe as initial, interim, or even definitive treatment of patients with severe acute cholecystitis who are at high operative risk for immediate cholecystectomy.
Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.