Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis when surgery is not an option
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3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 9 sources, which was discussed by the committee. The evidence included 3 systematic reviews, 1 randomised controlled trial, 2 non-randomised comparative studies, 1 registry, 1 case series and 1 case report. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: effective drainage of gallbladder, resolution of sepsis, and symptom relief, including reduction in pain and improvement in quality of life.
3.3 The professional experts and the committee considered the key safety outcomes to be: pain, infection, damage to adjacent structures, bile leak and need for further intervention.
3.4 Two commentaries from people who have had this procedure were discussed by the committee.
Committee comments
3.5 The committee was informed that people may need post-procedure follow up and this may involve more than 1 speciality.
3.6 The committee was informed that a training programme for the procedure is provided by a company that makes a device used in this procedure.
3.7 The committee was informed that clinicians who wish to do this procedure need a period of training in endoscopic ultrasound-guided techniques for other procedures.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
February 2023
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