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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Endoscopic Transpapillary Gallbladder Drainage for Acute Cholecystitis After Biliary Self-Expandable Metal Stent
Kazunari Nakahara1, Ryo Morita1, Yosuke Michikawa1
1Departments of Gastroenterology and Hepatology.
Summary
Endoscopic transpapillary gallbladder drainage (ETGBD) offers good outcomes for acute cholecystitis (AC) following self-expandable metal stent (SEMS) placement. This procedure demonstrates a high technical and clinical success rate with manageable adverse events.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Biliary Interventions
Background:
- Acute cholecystitis (AC) post-self-expandable metal stent (SEMS) placement presents technical challenges for endoscopic transpapillary gallbladder drainage (ETGBD).
- Limited data exists on the outcomes of ETGBD in patients with AC after SEMS placement.
Purpose of the Study:
- To evaluate the outcomes of endoscopic transpapillary gallbladder drainage (ETGBD) in patients with acute cholecystitis (AC) following self-expandable metal stent (SEMS) placement.
Main Methods:
- Retrospective analysis of 12 patients who underwent ETGBD for AC after SEMS placement between April 2011 and April 2019.
- ETGBD technique varied based on SEMS type (covered vs. uncovered) and location (distal vs. perihilar).
Main Results:
- Technical success rate for ETGBD was 83.3% (10/12), with higher success in perihilar SEMS (100%) compared to distal SEMS (75.0%).
- Clinical success rate for AC was 90.0% (9/10) in technically successful cases.
- Adverse events occurred in 16.7% (2/12) of patients, including stent kink and tube self-removal.
Conclusions:
- Endoscopic transpapillary gallbladder drainage (ETGBD) is a viable option for managing acute cholecystitis (AC) in patients with prior self-expandable metal stent (SEMS) placement.
- The procedure demonstrates relatively good outcomes and acceptable safety profile.
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