内視鏡的胆嚢ステント留置後4年経過した再発性胆嚢炎に対する内瘻・外瘻ドレナージを併用した内視鏡的胆嚢ドレナージの成功例
Takuya Koizumi1, Akinori Maruta1, Yosuke Ohashi1
1First Department of Internal Medicine, Gifu University Hospital, Gifu, JPN.
Abstract:
Recurrent cholecystitis can occur even after permanent endoscopic gallbladder stenting (EGBS), and optimal management in such situations remains challenging. In the present case, endoscopic transpapillary gallbladder drainage (ETGBD) was successfully achieved by using the indwelling EGBS to facilitate guidewire access to the gallbladder. Endoscopic nasobiliary gallbladder drainage was also placed, enabling combined internal and external drainage. The patient experienced a favorable clinical course following this approach. This case suggests that ETGBD is a feasible therapeutic option for recurrent cholecystitis after permanent EGBS placement, with the pre-existing stent aiding in gallbladder cannulation. Combined drainage may be particularly advantageous in the setting of purulent bile to ensure effective decompression.
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