Abstract
An early decision regarding the treatment strategy for acute cholecystitis is extremely important, as patients are often elderly and have other diseases and complications. The aim of this study is to compare the efficacy and usefulness of percutaneous transhepatic gallbladder drainage (PTGBD) and percutaneous transhepatic gallbladder aspiration (PTGBA) as the initial treatment for patients with acute cholecystitis. (Patients and methods): From January 2000 to August 2003, 19 patients with acute cholecystitis for whom drainage was needed were treated with PTGBD, and 16 patients with PTGBA. We compared the efficacy, usefulness, and side effects of those two procedures. (Results): Patients became asymptomatic, and their objective findings and laboratory data improved remarkably after the first procedure in all cases of PTGBA. The ease of procedure was an advantage, and patients could safely proceed to the next step, such as a scheduled operation or conservative treatment. On the other hand, although PTGBD is more reliable than PTGBA, it limits the patients' activity. It is also often painful, and there is a possibility of dislocation of the PTGBD tubes. These are great disadvantages, especially for elderly patients. (Conclusion) The short term efficacy of PTGBA and PTGBD is the same. However PTGBA is safer than PTGBD. It should be the initial treatment of choice for patients with acute cholecystitis, especially for the elderly.
