Endoscopic Ultrasound-Guided Gallbladder Drainage Versus Percutaneous Transhepatic Gallbladder Drainage for Acute Cholecystitis with High Surgical Risk: An Up-to-Date Meta-Analysis and Systematic Review

作者：Yunxiao Lyu, Ting Li, Bin Wang, Yunxiao Cheng, Liang Chen, Sicong Zhao · 发表于：Journal of Laparoendoscopic & Advanced Surgical Techniques · 年份：2021 · DOI：10.1089/lap.2020.0786 · 被引用次数：15 · 研究领域：Gallbladder and Bile Duct Disorders、Pancreatic and Hepatic Oncology Research、Appendicitis Diagnosis and Management

Background: To compare the safety and effectiveness of endoscopic ultrasound-guided gallbladder drainage (EUSGBD) with percutaneous transhepatic gallbladder drainage (PTGBD) for acute cholecystitis with high surgical risk. Methods: An electronic search was performed of the major databases, namely PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov until July 1, 2020. Studies comparing EUSGBD with PTGBD were included. Results: We identified 8 studies involving 801 patients, and patients were divided into two groups (EUSGBD group = 338 and PTGBD = 463). EUSGBD was associated with less reintervention (odds ratio [OR] = 0.15; 95% confidence interval [CI]: 0.07–0.32; P < .00001) and readmission (OR = 0.24; 95% CI: 0.08–0.67; P = 7). With lumen-apposing metal stents (LAMS), EUSGBD was associated with fewer adverse events (OR = 0.35; 95% CI: 0.13–0.93; P = .03), recurrent cholecystitis (OR = 0.27; 95% CI: 0.10–0.71; P = .008) and readmission (OR = 0.10; 95% CI: 0.03–0.32; P = .0001). There were no significant differences between the groups regarding clinical success (OR = 1.47; 95% CI: 0.75–2.90; P = .26). Technical success with PTGBD was higher than that with EUSGBD (OR = 0.32; 95% CI: 0.13–0.83; P = .02). Conclusions: EUSGBD was comparable with PTGBD regarding clinical success, with less reintervention and readmission, for acute cholecystitis with high surgical risk. The cholecystitis recurrence rate was lower with EUSGBD with...