[Transpapillary gallbladder drainage with 'pigtail' stent]

The transpapillary double 'pigtail' stent is placed endoscopically to drain the gallbladder after remission of a (recurrent) acute cholecystitis in patients with increased surgical risk. Technical success rate (placement of stent) is 83-88% and clinical success rate (remission of symptoms) is 80-93%. Although the procedure is effective, the stent is not commonly implemented. Possibly due to the challenging procedure or the introduction of the transgastric or transduodenic drainage with the Lumen Apposing Metal Stent (LAMS). This technique has a technical and clinical success rate of 94-95% and 90-97% respectively, significantly higher than the transpapillary stent. The LAMS can be placed during an acute cholecystitis. However, a cholecystectomy is contraindicated afterwards. Although the two procedures are complementary, future studies will tell if these two procedures will both continue to be used.