Clinical Research Of EUS-guided Gallbladder Drainage In High-risk Acute Cholecystitis With No Surgical Conditions

Objective The clinical efficacy and safety of endoscopic ultrasonography guided percutaneous cholecystectomy(EUS-GBD)in the treatment of high-risk acute cholecystitis were evaluated by comparison with percutaneous transhepatic gallbladder drainage(PTGBD).Methods Patients with acute high-risk cholecystitis attending our department from January 2016 to December 2017 were enrolled in the EUS-GBD treatment,The clinical data of the patients were collected,and reviewed clinical data of January 2016-December 2017 In our department of acute cholecystitis in patients with PTGBD,comparative analysis of two methods of efficacy and safety.Results There were 18 cases in EUS-GBD group,17 cases were operated successfully,the success rate was 94.4%.All patients were treated with plastic stent or nasobiliary duct.The clinical remission rate was 100%,bleeding occurred in 1 patients,complication rate was 5.6%,stent displacement rate was 0%No deaths,the average operation time of 27.6 ± 4.9 minutes,the average hospitalization date of 6.2 ±1.3 days,no recurrence of cholecystitis.There were 57cases in PTGBD group,56 cases were operated successfully,the success rate was 98.2%,the clinical remission rate was 89.3%,the complication rate was 10.5%and drainage tube slipping rate was 8.9%,no death,the average operation time was 6.0 ± 1.6 minutes,the average hospitalization date 29.5 ± 28.0 days,the recurrence rate of cholecystitis was 12.8%.Conclusion At an experienced endoscopy center,EUS-GBD is a safe and effective minimally invasive treatment for patients with high-risk acute cholecystitis without surgery.