Endoscopic gallbladder drainage for acute cholecystitis

Jessica Widmer, Paloma Alvarez, Reem Z. Sharaiha, Sonia Gossain, Prashant Kedia, Savreet Sarkaria, Amrita Sethi, Brian G. Turner, Jennifer Millman, Michael Lieberman, Govind Nandakumar, Hiren Umrania, Monica Gaidhane, Michel Kahaleh

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Background/Aims: Surgery is the mainstay of treatment for cholecystitis. However, gallbladder stenting (GBS) has shown promise in debilitated or high-risk patients. Endoscopic transpapillary GBS and endoscopic ultrasound-guided GBS (EUS-GBS) have been proposed as safe and effective modalities for gallbladder drainage. Methods: Data from patients with cholecystitis were prospectively collected from August 2004 to May 2013 from two United States academic university hospitals and analyzed retrospectively. The following treatment algorithm was adopted. Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and cystic duct stenting was initially attempted. If deemed feasible by the endoscopist, EUS-GBS was then pursued. Results: During the study period, 139 patients underwent endoscopic gallbladder drainage. Among these, drainage was performed in 94 and 45 cases for benign and malignant indications, respectively. Successful endoscopic gallbladder drainage was defined as decompression of the gallbladder without incidence of cholecystitis, and was achieved with ERCP and cystic duct stenting in 117 of 128 cases (91%). Successful endoscopic gallbladder drainage was also achieved with EUS-guided gallbladder drainage using transmural stent placement in 11 of 11 cases (100%). Complications occurred in 11 cases (8%). Conclusions: Endoscopic gallbladder drainage techniques are safe and efficacious methods for gallbladder decompression in nonsurgical patients with comorbidities.

Original languageEnglish (US)
Pages (from-to)411-420
Number of pages10
JournalClinical Endoscopy
Volume48
Issue number5
DOIs
StatePublished - Sep 2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Keywords

  • Cholecystitis
  • Endoscopic ultrasound-guided gallbladder drainage
  • Fully covered self-expanding metal stent
  • Metal stent
  • Transgastric

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