Cholecystitis, Acute Clinical Trial
Official title:
Endoscopic Naso-gallbladder Drainage Versus Gallbladder Stenting Before Elective Cholecystectomy in Patients With Acute Cholecystitis and a High Suspicion of Common Bile Duct Stone; A Prospective Randomized Preliminary Study
Early laparoscopic cholecystectomy is the current standard therapy for acute cholecystitis,
but temporary decompression of the gallbladder (GB) through percutaneous or endoscopic route
can be required to alleviate inflammatory process and reach an appropriate time for elective
surgery in patients with high operative risk or marked local inflammation or organ
dysfunction. Also preoperative endoscopic retrograde cholangiopancreatography (ERCP) is
often needed because common bile duct (CBD) stone is accompanied in patients with acute
cholecystitis at reported rate from 7-20%.
Two-steps approach of percutaneous transhepatic GB drainage (PTGBD) followed by ERCP or vice
versa has been performed for the treatment of acute cholecystitis with concomitant CBD stone
who are not suitable for urgent cholecystectomy. However single-step drainage of CBD and GB
through ERCP and endoscopic transpapillary GB drainage (ETGD) using nasocystic tube or
plastic stent has alternatively been attempted in patients who have contraindications for
PTGBD. In clinical practice, many endoscopists have hesitated to perform ETGD because of its
relatively low technical success rate and specific concern about post-ERCP adverse event but
it minimizes catheter keeping duration, and provides effective clinical improvement via
physiologic route.
Currently there are scarce data on if ETGD using nasocystic tube or plastic stent are
comparable in terms of clinical efficacy and safety.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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