Comparison of Conventional vs. Modified Seldinger Technique in Percutaneous Cholecystostomy and Evaluation of Procedural Efficiency and Safety
Öz
Background/Aims: To assess the effectiveness and safety of a modified Seldinger technique (MST), bypassing consecutive dilatation steps, versus the conventional Seldinger technique (CST) in percutaneous cholecystectomy (PC).
Methods: We performed a retrospective observational cohort analysis utilizing a de-identified dataset covering a period of 2 years (2021-2023) in a significant tertiary-level healthcare facility in Turkey.
Results: 152 individuals underwent successful PC. No significant differences were found regarding demographic, clinical, or laboratory characteristics between the CST and MST groups, indicating comparable patient profiles. The clinical efficacy rates were comparable between the two trial cohorts (85% in the CST versus 88.5 in the MST group; p = 0.547). The MST group had significantly shorter procedural time compared to the CST (4.24 ± 1.52 vs 2.85 ± 1.31, p=0.001). Safety profiles were similar between groups (p = 0.486), with minor bleeding resolving spontaneously in one patient per group and no major complications observed. Pain during the CST procedure was significantly higher than in the MST group, though this difference did not persist at the 12-hour follow-up (p = 0.01and 0.6, retrospectively).
Conclusion: The utilization of the MST technique for PC demonstrated comparable efficacy and safety to the CST. However, MST was found to be associated with a lower incidence of complications related to the procedure, and required less time to perform, when compared to the CST.
Anahtar Kelimeler
Modified Seldinger Technique, Percutaneous Cholecystostomy, Cholecystostomy
Kaynakça
- 1. Gallaher JR, Charles A. Acute Cholecystitis: A Review. Jama. 2022;327(10):965-75.
- 2. Okamoto K, Suzuki K, Takada T, Strasberg SM, Asbun HJ, Endo I, et al. Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. Journal of hepato-biliary-pancreatic sciences. 2018;25(1):55-72.
- 3. Palanivelu C, Jani K, Maheshkumar GS. Single-center experience of laparoscopic cholecystectomy. Journal of laparoendoscopic & advanced surgical techniques Part A. 2007;17(5):608-14.
- 4. Pisano M, Allievi N, Gurusamy K, Borzellino G, Cimbanassi S, Boerna D, et al. 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis. World J Emerg Surg. 2020;15(1):61.
- 5. Lucocq J, Patil P, Scollay J. Acute cholecystitis: Delayed cholecystectomy has lesser perioperative morbidity compared to emergency cholecystectomy. Surgery. 2022;172(1):16-22.
- 6. Leveau P, Andersson E, Carlgren I, Willner J, Andersson R. Percutaneous cholecystostomy: a bridge to surgery or definite management of acute cholecystitis in high-risk patients? Scandinavian journal of gastroenterology. 2008;43(5):593-6.
- 7. Arkoudis NA, Moschovaki-Zeiger O, Reppas L, Grigoriadis S, Alexopoulou E, Brountzos E, et al. Percutaneous cholecystostomy: techniques and applications. Abdominal radiology (New York). 2023;48(10):3229-42.
- 8. Little MW, Briggs JH, Tapping CR, Bratby MJ, Anthony S, Phillips-Hughes J, et al. Percutaneous cholecystostomy: the radiologist's role in treating acute cholecystitis. Clin Radiol. 2013;68(7):654-60.
- 9. Saad WE, Wallace MJ, Wojak JC, Kundu S, Cardella JF. Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. J Vasc Interv Radiol. 2010;21(6):789-95.
- 10. Morales-Maza J, Rodríguez-Quintero JH, Santes O, Hernández-Villegas AC, Clemente-Gutiérrez U, Sánchez-Morales GE, et al. Percutaneous cholecystostomy as a treatment for acute cholecystitis: What has happened over the last five years? A literature review. Revista de gastroenterologia de Mexico (English). 2019;84(4):482-91.