한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제27권1호
  • /
  • Pages.56-62
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  • 2023
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  • 2508-5778(pISSN)
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  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
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Outcomes of endoscopic retrograde cholangiopancreatography-guided gallbladder drainage compared to percutaneous cholecystostomy in acute cholecystitis

  • Hassam Ali (Department of Gastroenterology, East Carolina University/Vidant Medical Center) ;
  • Sheena Shamoon (Department of Internal Medicine, Rawalpindi Medical University) ;
  • Nicole Leigh Bolick (Department of Dermatology, University of New Mexico) ;
  • Swethaa Manickam (Department of Gastroenterology, East Carolina University/Vidant Medical Center) ;
  • Usama Sattar (Department of Internal Medicine, Quaid-e-Azam Medical College) ;
  • Shiva Poola (Department of Gastroenterology, East Carolina University/Vidant Medical Center) ;
  • Prashant Mudireddy (Department of Gastroenterology, East Carolina University/Vidant Medical Center)
  • 투고 : 2022.08.17
  • 심사 : 2022.09.20
  • 발행 : 2023.02.28
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초록

Backgrounds/Aims: Endoscopic retrograde cholangiopancreatography-guided gallbladder drainage (ERGD) is an alternative to percutaneous cholecystostomy (PTC) for hospitalized acute cholecystitis (AC) patients. Methods: We retrospectively analyzed propensity score matched (PSM) AC hospitalizations using the National Inpatient Sample database between 2016 and 2019 to compare the outcomes of ERGD and PTC. Results: After PSM, there were 3,360 AC hospitalizations, with 48.8% undergoing PTC and 51.2% undergoing ERGD. There was no difference in median length of stay between the PTC and ERGD cohorts (p = 0.110). There was a higher median hospitalization cost in the ERGD cohort, $62,562 (interquartile range [IQR] $40,707-97,978) compared to PTC, $40,413 (IQR $25,244-65,608; p < 0.001). The 30-day inpatient mortality was significantly lower in hospitalizations with ERGD compared to PTC (adjusted hazard ratio 0.16, 95% confidence interval [CI]: 0.1-0.41; p < 0.001). There was no difference in association with blood transfusions, acute renal failure, ileus, small bowel obstruction, and open cholecystectomy conversion (p > 0.05) between hospitalizations with ERGD and PTC. There was lower association of acute hypoxic respiratory failure (adjusted ratio [AOR] 0.46, 95% CI: 0.29-0.72; p = 0.001), hypovolemia (AOR 0.66, 95% CI: 0.49-0.82; p = 0.009) and higher association of lower gastrointestinal bleed (AOR 1.94, 95% CI: 1.48-2.54; p < 0.001) with ERGD compared to PTC. Conclusions: ERGD is a safer alternative to PTC in patients with AC. The risk complications are lower in ERGD compared to PTC but no difference exists based on mortality or conversion to open cholecystectomy.

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참고문헌

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