Endoscopic Gallbladder Stenting to Prevent Recurrent Cholecystitis in Deferred Cholecystectomy: A Randomized Trial

Area of Science:

• Gastroenterology
• Surgical Innovation
• Clinical Outcomes Research

Background:

• Acute cholecystitis management often involves delayed surgery.
• Endoscopic transpapillary gallbladder stenting (ETGS) is an adjunctive therapy for selected patients.
• Comparative data on ETGS outcomes were previously lacking.

Purpose of the Study:

• To compare recurrent cholecystitis rates at 3 and 6 months.
• Evaluate the efficacy of ETGS in patients with deferred cholecystectomy.
• Assess ETGS as an intervention for acute cholecystitis.

Main Methods:

• Randomized controlled trial involving 120 patients with acute calculous cholecystitis and high probability of common bile duct stones.
• Group A received ETGS; Group B did not. Both groups underwent cholecystectomy later.
• Intention-to-treat analysis was performed.

Main Results:

• Group A (ETGS) showed a significantly lower recurrence rate at 3 months (0% vs 18.3%, P=.001).
• Technical and clinical success rates for ETGS were 90% and 100%, respectively.
• A non-significantly lower recurrence rate was observed in Group A between 3-6 months (0% vs 10%, P=.11).

Conclusions:

• ETGS effectively prevents recurrent cholecystitis when cholecystectomy is deferred.
• Recurrences in the non-stented group predominantly occurred within 3 months.
• ETGS is a viable option for managing acute cholecystitis in specific patient cohorts.