Endoscopic Ultrasonography-Guided Gallbladder Drainage as a Treatment Option for Acute Cholecystitis after Metal Stent Placement in Malignant Biliary Strictures
Clinical Endoscopy
;
: 262-268, 2019.
Article
in English
| WPRIM
| ID: wpr-763432
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Bile
/
Stents
/
Drainage
/
Retrospective Studies
/
Treatment Outcome
/
Constriction, Pathologic
/
Cholecystitis, Acute
/
Joint Dislocations
/
Gallbladder
Type of study:
Observational study
Limits:
Humans
Language:
English
Journal:
Clinical Endoscopy
Year:
2019
Type:
Article
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