{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:42:25Z","timestamp":1791877345530,"version":"4.3.4"},"reference-count":30,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objective: Percutaneous transhepatic gallbladder drainage (PTGBD) is commonly used in patients with acute cholecystitis (AC) who are unfit for early laparoscopic cholecystectomy (LC). However, the efficacy, safety and long-term role of PTGBD remain debated. We aimed to evaluate the effectiveness and safety of PTGBD in managing AC, focusing on infection control, procedure-related complications, and need for secondary surgical intervention. Methods: We performed a single-center retrospective study including all patients who underwent PTGBD for AC from January 2018 to December 2023 at a tertiary care hospital. Patients were identified through an institutional database. Relevant clinical, procedural, and outcome data were extracted from electronic medical records. The primary outcome was infection control, defined as clinical and biochemical resolution of AC without the need for additional interventions beyond antibiotic therapy. Secondary outcomes included PTGBD-related complications, 30-day mortality, length of hospital stay, readmission rate, and the rate of subsequent LC. Results: A total of 105 patients were included (mean age 69.9 years; 63.8% male). Infection control was observed in 92.4% of patients following PTGBD. PTGBD-related complications occurred in 36.2%, mainly drain dislodgement and recurrent cholecystitis. Mortality was 4.8%. Delayed LC was performed in 80.9% of patients, with a 10.6% conversion rate and 16.5% postoperative complication rate. Conclusions: PTGBD is effective for infection control in high-risk AC patients unfit for immediate surgery. However, the complication rate and the frequent need for delayed LC underscore the importance of careful patient selection and standardized management strategies.<\/jats:p>","DOI":"10.3390\/jcm14227955","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T15:07:31Z","timestamp":1762787251000},"page":"7955","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Value of Percutaneous Transhepatic Gallbladder Drainage for Advanced Acute Cholecystitis as a Bridging Procedure: A Single-Center Retrospective Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8634-0223","authenticated-orcid":false,"given":"Benoit","family":"Geng","sequence":"first","affiliation":[{"name":"Department of Surgery, Cantonal Hospital of Fribourg, Chemin des Pensionnats 2\/6, 1752 Villars-sur-Gl\u00e2ne, Switzerland"},{"name":"Department of Medical and Surgical Specialties, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaella","family":"Sguinzi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cantonal Hospital of Fribourg, Chemin des Pensionnats 2\/6, 1752 Villars-sur-Gl\u00e2ne, Switzerland"},{"name":"Department of Medical and Surgical Specialties, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Litchinko","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cantonal Hospital of Fribourg, Chemin des Pensionnats 2\/6, 1752 Villars-sur-Gl\u00e2ne, Switzerland"},{"name":"Department of Medical and Surgical Specialties, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1194-6393","authenticated-orcid":false,"given":"Beno\u00eet","family":"Gremaud","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Froment","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cantonal Hospital of Fribourg, Chemin des Pensionnats 2\/6, 1752 Villars-sur-Gl\u00e2ne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5464-6953","authenticated-orcid":false,"given":"Michel","family":"Adamina","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland"},{"name":"Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2804","DOI":"10.1056\/NEJMcp0800929","article-title":"Acute Calculous Cholecystitis","volume":"358","author":"Strasberg","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s13017-016-0082-5","article-title":"2016 WSES guidelines on acute calculous cholecystitis","volume":"11","author":"Ansaloni","year":"2016","journal-title":"World J. Emerg. Surg."},{"key":"ref_3","first-page":"9709242","article-title":"Acute Cholecystitis in Very Elderly Patients: Disease Management, Outcomes, and Risk Factors for Complications","volume":"2019","author":"Cuello","year":"2019","journal-title":"Surg. Res. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1159\/000455241","article-title":"Early Cholecystectomy for Acute Cholecystitis in the Elderly Population: A Systematic Review and Meta-Analysis","volume":"34","author":"Loozen","year":"2017","journal-title":"Dig. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1111\/ans.70268","article-title":"Management of Acute Gallstone Disease in Older Adults and Associated Outcomes","volume":"95","author":"Junker","year":"2025","journal-title":"ANZ J. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Canakis, A., Tugarinov, N., Deliwala, S., Twery, B., Miro-Gonzalez, \u00c1., Beran, A., Gorman, E.F., Hathorn, K., Gilman, A.J., and Chawla, S. (Gastrointest. Endosc., 2025). Clinical outcomes of EUS-guided gallbladder drainage in patients with acute cholecystitis with \u22651 year of follow-up: A systematic review and meta-analysis, Gastrointest. Endosc., in press.","DOI":"10.1016\/j.gie.2025.07.025"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1007\/s11605-015-2747-x","article-title":"Early Cholecystectomy Is Superior to Delayed Cholecystectomy for Acute Cholecystitis: A Meta-analysis","volume":"19","author":"Cao","year":"2015","journal-title":"J. Gastrointest. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1002\/jhbp.515","article-title":"Tokyo Guidelines 2018: Diagnostic criteria and severity grading of acute cholecystitis (with videos)","volume":"25","author":"Yokoe","year":"2018","journal-title":"J. Hepato-Biliary-Pancreat. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s13017-020-00336-x","article-title":"2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis","volume":"15","author":"Pisano","year":"2020","journal-title":"World J. Emerg. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"g6241","DOI":"10.1136\/bmj.g6241","article-title":"Diagnosis and management of gallstone disease: Summary of NICE guidance","volume":"349","author":"Warttig","year":"2014","journal-title":"BMJ"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s13304-023-01729-8","article-title":"Acute cholecystitis management in high-risk, critically ill, and unfit-for-surgery patients: The Italian Society of Emergency Surgery and Trauma (SICUT) guidelines","volume":"76","author":"CCoccolini","year":"2024","journal-title":"Updates Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3185","DOI":"10.1097\/JS9.0000000000002325","article-title":"Management of high-surgical-risk patients with acute cholecystitis following percutaneous cholecystostomy: Results of an international Delphi consensus study","volume":"111","author":"Pesce","year":"2025","journal-title":"Int. J. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"59","DOI":"10.14744\/tjtes.2024.94489","article-title":"Percutaneous cholecystostomy in elderly patients with acute cholecystitis: Factors influencing mortality, morbidity, and length of hospital stay","volume":"31","author":"Teke","year":"2025","journal-title":"Ulus Travma Acil Cerrahi Derg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Bozic, D., Ardalic, Z., Mestrovic, A., Ivisic, J.B., Alicic, D., Zaja, I., Ivanovic, T., Bozic, I., Puljiz, Z., and Bratanic, A. (2023). Assessment of Gallbladder Drainage Methods in the Treatment of Acute Cholecystitis: A Literature Review. Medicina, 60.","DOI":"10.3390\/medicina60010005"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00268-019-05117-5","article-title":"The Efficacy of PTGBD for Acute Cholecystitis Based on the Tokyo Guidelines 2018","volume":"43","author":"Abe","year":"2019","journal-title":"World J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1007\/s13304-023-01499-3","article-title":"Impact of percutaneous cholecystostomy in the management of acute cholecystitis: A retrospective cohort study at a tertiary center","volume":"75","author":"Morote","year":"2023","journal-title":"Updates Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1177\/1457496918798209","article-title":"Percutaneous Cholecystostomy for Severe Acute Cholecystitis: A Useful Procedure in High-Risk Patients for Surgery","volume":"108","author":"Aroori","year":"2019","journal-title":"Scand. J. Surg."},{"key":"ref_18","unstructured":"National Institute for Health and Care Excellence (NICE) (2025, July 28). Gallstone Disease: Diagnosis and Management of Cholelithiasis, Cholecystitis and Choledocholithiasis, National Institute for Health and Care Excellence: Guidelines, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK258747\/."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Tuncer, K., Kilinc Tuncer, G., and \u00c7al\u0131k, B. (2023). Factors affecting the recurrence of acute cholecystitis after treatment with percutaneous cholecystostomy. BMC Surg., 23.","DOI":"10.1186\/s12893-023-02042-2"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1111\/j.1477-2574.2012.00610.x","article-title":"Clinical outcomes of a percutaneous cholecystostomy for acute cholecystitis: A multicentre analysis","volume":"15","author":"Sanjay","year":"2013","journal-title":"HPB"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Hung, Y.L., Sung, C.M., Fu, C.Y., Liao, C.H., Wang, S.Y., Hsu, J.T., Yeh, T.-S., Yeh, C.-N., and Jan, Y.-Y. (2021). Management of Patients with Acute Cholecystitis After Percutaneous Cholecystostomy: From the Acute Stage to Definitive Surgical Treatment. Front. Surg., 8.","DOI":"10.3389\/fsurg.2021.616320"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"571","DOI":"10.21873\/cdp.10256","article-title":"Optimal Timing of Laparoscopic Cholecystectomy After Conservative Therapy for Acute Cholecystitis","volume":"3","author":"Enami","year":"2023","journal-title":"Cancer Diagn. Progn."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.hpb.2019.10.2438","article-title":"Timing of cholecystectomy after percutaneous transhepatic gallbladder drainage for acute cholecystitis: A nationwide inpatient database study","volume":"22","author":"Sakamoto","year":"2020","journal-title":"HPB"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1002\/jhbp.1012","article-title":"The optimal timing of interval laparoscopic cholecystectomy following percutaneous cholecystostomy based on pathological findings and the incidence of biliary events","volume":"28","author":"Hung","year":"2021","journal-title":"J. Hepato-Biliary-Pancreatic Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13017-024-00561-8","article-title":"International Delphi consensus on the management of percutaneous choleystostomy in acute cholecystitis (E-AHPBA, ANS, WSES societies)","volume":"19","author":"Ramia","year":"2024","journal-title":"World J. Emerg. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Inoue, T., Yoshida, M., Suzuki, Y., Kitano, R., Okumura, F., and Naitoh, I. (2021). Long-Term Outcomes of Endoscopic Gallbladder Drainage for Cholecystitis in Poor Surgical Candidates: An Updated Comprehensive Review. J. Clin. Med., 10.","DOI":"10.3390\/jcm10214842"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of Surgical Complications","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2850","DOI":"10.1007\/s00464-021-08573-0","article-title":"Surgical outcome of percutaneous transhepatic gallbladder drainage in acute cholecystitis: Ten years\u2019 experience at a tertiary care centre","volume":"36","author":"Matuz","year":"2022","journal-title":"Surg. Endosc."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Zanchetta, M., Adani, G.L., Micheletti, G., Poto, G.E., Piccioni, S.A., Carbone, L., Monteleone, I., Sandini, M., Marrelli, D., and Calomino, N. (2025). Perforated Calculous Cholecystitis and Incidental Squamous Cell Carcinoma of the Gallbladder-A Complex Relationship with a Difficult Management in the Acute Setting. Medicina, 61.","DOI":"10.3390\/medicina61030452"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Sadaka, A.H., Tseng, J.F., and Itani, K.M.F. (2025). Indications for and Optimal Management of Percutaneous Cholecystectomy Drainage: A Systematic Review. JAMA Surg., epub ahead of print.","DOI":"10.1001\/jamasurg.2025.3260"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/22\/7955\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T15:23:28Z","timestamp":1762788208000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/22\/7955"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,10]]},"references-count":30,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["jcm14227955"],"URL":"https:\/\/doi.org\/10.3390\/jcm14227955","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,10]]}}}