Gallbladder cryoablation for chronic cholecystitis in high-risk surgical patients: early clinical experience and imaging follow up

Presented During:

Sat, 6/13/2020: 1:08 PM  - 1:17 PM 
Webinar  
Room: Webinar  

Final ID:

99 

Authors:

H McGregor1, G Woodhead1, M Patel1, A Khan1, M Conrad2, C Hennemeyer1

Institutions:

1University of Arizona, Tucson, AZ, 2University of California, San Francisco, San Francisco, CA

First Author:

Hugh McGregor  
University of Arizona
Tucson, AZ

Co-Author(s):

Gregory John Woodhead, MD, PhD  
University of Arizona
Tucson, AZ
Mikin V. Patel, MD, MBA  
University of Arizona
Tucson, AZ
Abdul Khan, MD  
University of Arizona
Tucson, AZ
Miles B. Conrad, MD, MPH  
University of California, San Francisco
San Francisco, CA
Charles T. Hennemeyer, MD  
University of Arizona
Tucson, AZ

Presenting Author:

Hugh McGregor  
University of Arizona
Tucson, AZ

Purpose:

To assess the short-term safety and efficacy of gallbladder cryoablation in high-risk patients.

Materials:

Patients with cholecystitis previously treated with a cholecystostomy tube (n=6) or biliary colic (n=1), who were referred for gallbladder cryoablation between August 2018 and July 2019 were followed clinically and with imaging for 3-12 months. All patients had significant pre-procedural comorbidities and were deemed unacceptable surgical candidates by an attending surgeon. Primary efficacy measures were technical success of the procedure, absence of symptoms at 1 month, and imaging evidence of cystic duct obstruction and gallbladder devitalization. The primary safety measure was the presence/absence of the Society of Interventional Radiology's moderate or greater adverse events.

Results:

There was no peri-procedure, early (<30 day), or in-hospital mortality. Technical success was 86% with 1 of 7 patients unable to undergo cryoablation because of adhesions preventing hydrodissection of the colon away from the gallbladder. Abdominal pain was absent in all patients 1 month after ablation. At least 1 CT or MR was completed 1-6 months after ablation and demonstrated evidence of gallbladder involution in 4/6 patients. Hepatobiliary iminodiacetic acid scans were completed in 5/6 patients 1 month after ablation and demonstrated cystic duct occlusion in all 5 patients. One moderate and 1 life-threatening adverse event occurred.

Conclusions:

These early outcomes suggest that gallbladder cryoablation may be a viable treatment option for high-risk patients with gallbladder disease and warrant further investigation.

Abstract Categories:

Non-Vascular Interventions: Biliary

Keywords:

Cholecystostomy
Cryoablation
Gallbladder