Endoscopic Ultrasonography-Guided Gallbladder Drainage as a Treatment Option for Acute Cholecystitis after Metal Stent Placement in Malignant Biliary Strictures
- Author:
Fumisato KOZAKAI
1
;
Yoshihide KANNO
;
Kei ITO
;
Shinsuke KOSHITA
;
Takahisa OGAWA
;
Hiroaki KUSUNOSE
;
Kaori MASU
;
Toshitaka SAKAI
;
Toji MURABAYASHI
;
Keisuke YONAMINE
;
Yujiro KAWAKAMI
;
Yuki FUJII
;
Kazuaki MIYAMOTO
;
Yutaka NODA
Author Information
- Publication Type:Original Article
- Keywords: Unresectable malignant biliary stricture; Acute cholecystitis; Endscopic ultrasonography-guided gallbladder drainage; Percutaneous transhepatic gallbladder drainage; Percutaneous transhepatic gallbladder aspiration
- MeSH: Bile; Cholecystitis, Acute; Constriction, Pathologic; Dislocations; Drainage; Gallbladder; Humans; Retrospective Studies; Stents; Treatment Outcome
- From:Clinical Endoscopy 2019;52(3):262-268
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: It is often difficult to manage acute cholecystitis after metal stent (MS) placement in unresectable malignant biliary strictures. The aim of this study was to evaluate the feasibility of endoscopic ultrasonography-guided gallbladder drainage (EUS-GBD) for acute cholecystitis. METHODS: The clinical outcomes of 10 patients who underwent EUS-GBD for acute cholecystitis after MS placement between January 2011 and August 2018 were retrospectively evaluated. The procedural outcomes of percutaneous transhepatic gallbladder drainage (PTGBD) with tube placement (n=11 cases) and aspiration (PTGBA) (n=27 cases) during the study period were evaluated as a reference. RESULTS: The technical success and clinical effectiveness rates of EUS-GBD were 90% (9/10) and 89% (8/9), respectively. Severe bile leakage that required surgical treatment occurred in one case. Acute cholecystitis recurred after stent dislocation in 38% (3/8) of the cases. Both PTGBD and PTGBA were technically successful in all cases without severe adverse events and clinically effective in 91% and 63% of the cases, respectively. CONCLUSIONS: EUS-GBD after MS placement was a feasible option for treating acute cholecystitis. However, it was a rescue technique following the established percutaneous intervention in the current setting because of the immature technical methodology, including dedicated devices, which need further development.
