Two-Center Prospective Comparison of the Trocar and Seldinger Techniques for Percutaneous Cholecystostomy
OBJECTIVE. The purpose of this study is to compare the safety and efficacy of the bedside ultrasound (US)-guided trocar technique versus the US- and fluoroscopy-guided Seldinger technique for percutaneous cholecystostomy (PC). SUBJECTS AND METHODS. This prospective noninferiority study compared the bedside US-guided trocar technique for PC (the trocar group; 53 patients [28 men and 25 women]; mean [± SD] age, 74.31 ± 16.19 years) with the US- and fluoroscopy-guided Seldinger technique for PC (the Seldinger group; 52 patients [26 men and 26 women], mean age, 79.92 ± 13.38 years) in consecutive patients undergoing PC at two large tertiary university hospitals. The primary endpoints were technical success and procedure-related complication rates. Secondary endpoints included procedural duration, pain assessment, and clinical success after up to 3 months of follow-up. RESULTS. PC was successfully performed for all 105 patients. The clinical success rate was similar between the two study groups (86.8% in the trocar group vs 76.9% in the Seldinger group; p = 0.09). Mean procedural time was significantly lower in the trocar group than in the Seldinger group (1.77 ± 1.62 vs 4.88 ± 2.68 min; p < 0.0001). Significantly more procedure-related complications were noted in the Seldinger group than in the trocar group (11.5% vs 1.9%; p = 0.02). Among patients in the Seldinger group, bile leak occurred in 7.7%, abscess formation in 1.9%, and gallbladder rupture in 1.9%. No procedure-related death was noted. Minor bleeding occurred in one patient (1.9%) in the trocar group, but the bleeding resolved on its own. The mean pain score during the procedure was significantly lower in the Seldinger group than in the trocar group (3.2 ± 1.77 vs 4.76 ± 2.17; p = 0.01). At 12 hours after the procedure, the mean pain score was significantly lower for patients in the trocar group (0.78 ± 1.0 vs 3.12 ± 1.36; p = 0.0001). CONCLUSION. Use of the bedside US-guided trocar technique for PC was equally effective as the Seldinger technique but was associated with fewer procedure-related complications, required less procedural time, and resulted in decreased postprocedural pain, compared with fluoroscopically guided PC using the Seldinger technique.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:214 |
|---|---|
| Enthalten in: |
AJR. American journal of roentgenology - 214(2020), 1 vom: 01. Jan., Seite 206-212 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Reppas, Lazaros [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cholecystitis |
|---|
| Anmerkungen: |
Date Completed 22.04.2020 Date Revised 22.04.2020 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.2214/AJR.19.21685 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM301812772 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM301812772 | ||
| 003 | DE-627 | ||
| 005 | 20231225105414.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.2214/AJR.19.21685 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1006.xml |
| 035 | |a (DE-627)NLM301812772 | ||
| 035 | |a (NLM)31573856 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Reppas, Lazaros |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Two-Center Prospective Comparison of the Trocar and Seldinger Techniques for Percutaneous Cholecystostomy |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 22.04.2020 | ||
| 500 | |a Date Revised 22.04.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE. The purpose of this study is to compare the safety and efficacy of the bedside ultrasound (US)-guided trocar technique versus the US- and fluoroscopy-guided Seldinger technique for percutaneous cholecystostomy (PC). SUBJECTS AND METHODS. This prospective noninferiority study compared the bedside US-guided trocar technique for PC (the trocar group; 53 patients [28 men and 25 women]; mean [± SD] age, 74.31 ± 16.19 years) with the US- and fluoroscopy-guided Seldinger technique for PC (the Seldinger group; 52 patients [26 men and 26 women], mean age, 79.92 ± 13.38 years) in consecutive patients undergoing PC at two large tertiary university hospitals. The primary endpoints were technical success and procedure-related complication rates. Secondary endpoints included procedural duration, pain assessment, and clinical success after up to 3 months of follow-up. RESULTS. PC was successfully performed for all 105 patients. The clinical success rate was similar between the two study groups (86.8% in the trocar group vs 76.9% in the Seldinger group; p = 0.09). Mean procedural time was significantly lower in the trocar group than in the Seldinger group (1.77 ± 1.62 vs 4.88 ± 2.68 min; p < 0.0001). Significantly more procedure-related complications were noted in the Seldinger group than in the trocar group (11.5% vs 1.9%; p = 0.02). Among patients in the Seldinger group, bile leak occurred in 7.7%, abscess formation in 1.9%, and gallbladder rupture in 1.9%. No procedure-related death was noted. Minor bleeding occurred in one patient (1.9%) in the trocar group, but the bleeding resolved on its own. The mean pain score during the procedure was significantly lower in the Seldinger group than in the trocar group (3.2 ± 1.77 vs 4.76 ± 2.17; p = 0.01). At 12 hours after the procedure, the mean pain score was significantly lower for patients in the trocar group (0.78 ± 1.0 vs 3.12 ± 1.36; p = 0.0001). CONCLUSION. Use of the bedside US-guided trocar technique for PC was equally effective as the Seldinger technique but was associated with fewer procedure-related complications, required less procedural time, and resulted in decreased postprocedural pain, compared with fluoroscopically guided PC using the Seldinger technique | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Controlled Clinical Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Seldinger | |
| 650 | 4 | |a cholecystitis | |
| 650 | 4 | |a cholecystostomy | |
| 650 | 4 | |a fluoroscopy | |
| 650 | 4 | |a interventional | |
| 650 | 4 | |a trocar | |
| 700 | 1 | |a Arkoudis, Nikolaos-Achilleas |e verfasserin |4 aut | |
| 700 | 1 | |a Spiliopoulos, Stavros |e verfasserin |4 aut | |
| 700 | 1 | |a Theofanis, Michail |e verfasserin |4 aut | |
| 700 | 1 | |a Kitrou, Panagiotis M |e verfasserin |4 aut | |
| 700 | 1 | |a Katsanos, Konstantinos |e verfasserin |4 aut | |
| 700 | 1 | |a Palialexis, Konstantinos |e verfasserin |4 aut | |
| 700 | 1 | |a Filippiadis, Dimitris |e verfasserin |4 aut | |
| 700 | 1 | |a Kelekis, Alexis |e verfasserin |4 aut | |
| 700 | 1 | |a Karnabatidis, Dimitrios |e verfasserin |4 aut | |
| 700 | 1 | |a Kelekis, Nikolaos |e verfasserin |4 aut | |
| 700 | 1 | |a Brountzos, Elias |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t AJR. American journal of roentgenology |d 1981 |g 214(2020), 1 vom: 01. Jan., Seite 206-212 |w (DE-627)NLM000037109 |x 1546-3141 |7 nnns |
| 773 | 1 | 8 | |g volume:214 |g year:2020 |g number:1 |g day:01 |g month:01 |g pages:206-212 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.2214/AJR.19.21685 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 214 |j 2020 |e 1 |b 01 |c 01 |h 206-212 | ||