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[Transpapillary gallbladder drainage with 'pigtail' stent].

Masja K Toneman1,2, Lars E Perk3, Gijs J D van Acker1

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Transpapillary double pigtail stents offer gallbladder drainage for acute cholecystitis in high-risk patients. Lumen Apposing Metal Stents (LAMS) show higher success rates and can be used during acute inflammation.

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Area of Science:

  • Gastroenterology
  • Endoscopic Procedures
  • Biliary Interventions

Background:

  • Acute cholecystitis management often involves high-risk surgical candidates.
  • Endoscopic gallbladder drainage is an alternative to surgery.
  • Transpapillary double pigtail stents have been used for this purpose.

Purpose of the Study:

  • To evaluate the efficacy and implementation of transpapillary double pigtail stents for gallbladder drainage.
  • To compare the outcomes of transpapillary stents with newer techniques like Lumen Apposing Metal Stents (LAMS).

Main Methods:

  • Endoscopic placement of transpapillary double pigtail stents for gallbladder drainage.
  • Review of technical and clinical success rates for transpapillary stents.
  • Comparison with reported outcomes of LAMS for gallbladder drainage.

Main Results:

  • Transpapillary stent placement achieved technical success in 83-88% and clinical success in 80-93%.
  • LAMS demonstrated higher technical (94-95%) and clinical (90-97%) success rates.
  • LAMS can be placed during acute cholecystitis, unlike transpapillary stents which are used after remission.

Conclusions:

  • Transpapillary double pigtail stents are effective but less commonly used, possibly due to procedural challenges and superior LAMS outcomes.
  • LAMS offer a more successful endoscopic drainage option for acute cholecystitis.
  • Future research will clarify the continued roles of both complementary procedures.