Gastrointestinal Interventions

Session: Educational Exhibit Presentations - Station 4: Gastrointestinal Interventions

Cryo- and Chemical Ablation of the Gallbladder: Review of Available and Emerging Interventional Therapies for Non-surgical Cholecystitis

Monday, March 6, 2023

5:35 PM – 5:40 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

Mensur Koso, BS

Medical Student
The Ohio State University College of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Mina S. Makary, MD (he/him/his)

Interventional Radiologist
The Ohio State University Wexner Medical Center

Disclosure(s):

Mensur Koso, BS: No financial relationships to disclose

Mina S. Makary, MD: No financial relationships to disclose

Learning Objectives: To review available gallbladder ablative interventions, evolving techniques, and indications and outcomes of ablative therapies for cholecystitis.

Background: Gallbladder disease affects over 20 million adults, with cholecystitis representing a common and emergent indication for surgery. Though laparoscopic cholecystectomy represents the first-line approach to cholecystitis with excellent outcomes, there is a subset of patients who are poor surgical candidates and require alternative treatments. Percutaneous cholecystostomy drainage of the gallbladder is the preferred route of treatment for non-surgical cholecystitis, though the technique is associated with complications, recurrence of disease, and diminished quality of life. Alternative therapies have been sought to fill the role of a minimally-invasive approach with acceptable side-effects. Ablative techniques of the gallbladder using chemical agents have been in development first in animal models beginning in the 1980’s. Since then, various chemical and cryo-ablative interventions have emerged as potentially effective treatment options.

Clinical Findings/Procedure Details: This educational exhibit will cover a 1) review of the pathogenesis and disease burden of cholecystitis, 2) review current first-line treatments and common alternatives for cholecystitis treatment, 3) analyze the role and indications for ablative treatment of cholecystitis, 4) review early ablative gallbladder interventions with a focus on chemical ablation, 5) describe emerging ablative gallbladder techniques with a focus on cryo- and chemical ablation with adjunct cystic duct embolization, 6) describe the technical procedural details of gallbladder ablative techniques, 7) evaluate current literature and clinical outcomes, and 8) discuss future considerations and directions of gallbladder ablation.

Conclusion and/or Teaching Points: After reviewing the exhibit, the viewer will gain a deeper understanding of the role of gallbladder ablative interventional techniques in the appropriate candidates, the technical procedural details of the intervention, and important considerations and outcomes of this approach.