Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

Table 1 Demographics, clinical characteristics and laboratory values of patients in the percutaneous transhepatic gallbladder drainage and percutaneous transperitoneal gallbladder drainage groups, n (%)

	PHGD group, n = 58	PPGD group, n = 45	P value
Age	73.8 ± 11.6	74.8 ± 12.2	0.672
Sex, male/female	31/27	24/21	0.991
BMI in kg/m2	22.8 ± 0.6	23.1 ± 0.8	0.320
Comorbidity, n (%)	49 (84.5)	41 (91.1)	0.315
Hypertension	29 (50.0)	27 (60.0)	0.312
Diabetes	26 (44.8)	16 (35.6)	0.342
Arrhythmia	4 (6.9)	4 (8.9)	0.997
CHD	21 (36.2)	16 (35.6)	0.946
COPD	3 (5.2)	4 (8.9)	0.427
CI	9 (15.5)	6 (13.3)	0.755
CRI	1 (1.7)	1 (2.2)	> 0.999
Others	10 (17.2)	6 (13.3)	0.105
Previous abdominal surgery, n (%)	10 (17.2)	7 (15.6)	0.819
Appendectomy	3 (5.2)	2 (4.4)	> 0.999
Cesarean	6 (10.3)	3 (6.7)	0.699
Oophorectomy	1 (1.7)	2 (4.4)	0.823
ASA grade average	2.3 ± 0.4	2.3 ± 0.5	0.872
Tokyo Guidelines 2018			0.918
Grade I	5 (8.6)	3 (5.2)
Grade II	46 (79.3)	37 (82.2)
Grade III	7 (12.1)	5 (11.1)
Body temperature in °C	37.4 ± 0.87	37.4 ± 0.90	0.506
Positive Murphy’s sign, n (%)	40 (69.0)	34 (75.6)	0.461
Leukocytes counts ,×109/L	15.8 ± 3.2	15.9 ± 3.0	0.872
PLT, ×106/L	241.7 ± 70.2	238.2 ± 68.3	0.800
ALT, U/L	53.2 ± 17.9	51.2 ± 18.3	0.579
AST, U/L	60.0 ± 18.9	53.2 ± 20.0	0.080
TB, μmol/L	45.2 ± 24.6	47.8 ± 24.9	0.598
PT in s	13.9 ± 2.0	14.1 ± 2.2	0.631
INR	1.2 ± 0.2	1.3 ± 0.3	0.045a
Gallbladder size in cm	10.6 ± 2.0	10.8 ± 2.2	0.631
Gallbladder wall thickness in mm	6.6 ± 2.2	6.9 ± 2.3	0.503
Duration from onset to PC in h	62.4 ± 11.5	57.6 ± 12.2	0.043 a
Interval from PC to elective LC in d	34.5 ± 4.7	33.9 ± 4.2	0.503

Note: All baseline characteristics and clinical data and outcomes did not differ significantly between groups except for the international normalized ratio and duration from onset to PC (^aP < 0.05). PHGD: Percutaneous transhepatic gallbladder drainage; PPGD: Percutaneous transperitoneal gallbladder drainage; COPD: Chronic obstructive pulmonary disease; CHD: Coronary heart disease; CI: Cerebral infarction; CRI: Chronic renal insufficiency; PC: Percutaneous cholecystostomy; LC: Laparoscopic cholecystectomy; INR: International normalized ratio; PT: Prothrombin time; PLT: Platelet; ALT: Alanine transaminase; AST: Aspartate aminotransferase; TB: Total bilirubin; ASA: American Society of Anesthesiology; BMI: Body mass index.

Table 2 Procedural details, postprocedural hospital course and complications in percutaneous transhepatic gallbladder drainage and percutaneous transperitoneal gallbladder drainage groups, n (%)

	PHGD group, n = 58	PPGD group, n = 45	P value
Puncture site, subcostal/ intercostal	4/54	44/1	0.001b
Procedure duration in min	6.7 ± 2.1	6.8 ± 2.2	0.693
Bile culture performed, %	20 (43.1)	18 (40.0)	0.565
Bile culture positive, %	19 (32.8)	18 (40.0)	0.447
Postprocedural fluoroscopy, %	45 (77.6)	39 (86.7)	0.239
Pain score
During puncture	3.1 ± 1.9	4.5 ± 1.7	0.001b
At 12 h follow-up	1.5 ± 0.7	2.2 ± 0.8	0.001b
Fever and chills within 24 h after PC, %	8 (13.8)	19 (42.2)	0.001b
Local bleeding at PC site, %	12 (20.7)	1 (2.2)	0.005b
Days from PC to discharge	4.8 ± 2.2	4.7 ± 2.5	0.830

^bP < 0.01. PHGD: Percutaneous transhepatic gallbladder drainage; PPGD: Percutaneous transperitoneal gallbladder drainage; PC: Percutaneous cholecystostomy.

Table 3 Comparison of surgical results of laparoscopic cholecystostomy in patients between percutaneous transhepatic gallbladder drainage and percutaneous transperitoneal gallbladder drainage groups, n (%)

	PHGD group, n = 58	PPGD group, n = 45	P value
Operative duration in min	118.3 ± 34.7	139.6 ± 37.2	0.001b
Intraoperative bleeding, mL	72.1 ± 30.5	109.4 ± 33.6	0.001b
Conversion to laparotomy, %	9 (15.5)	11 (24.4)	0.256
Subtotal cholecystectomy, %	5 (8.6)	2 (4.4)	0.404
Rate of severe adhesion, mild/ severe	26/32	29/16	0.048a
complications	3 (5.2)	4 (8.9)	0.457
Bile leak	1	1	> 0.999
Bleeding	0	1	> 0.898
Wound infection	1	0	> 0.999
Pulmonary infection	1	1	> 0.999
Deep vein thrombosis of lower extremity	0	1	> 0.898
Pathology, acute/ chronic	22/36	18/27	0.831
Hospital length of stay in d	14.3 ± 4.4	18.0 ± 4.8	0.001b

^aP < 0.05;

^bP < 0.01. PHGD: Percutaneous transhepatic gallbladder drainage; PPGD: Percutaneous transperitoneal gallbladder drainage.