Feasibility and safety of endoscopic ultrasound-guided gallbladder drainage using a newly designed lumen-apposing metal stent
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Background and aims
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is increasingly accepted as an effective treatment option in patients who require drainage for acute cholecystitis. A newly designed lumen-apposing metal stent (LAMS) has been introduced recently in this procedure. In this study, we evaluated the feasibility and safety of the newly designed LAMS in patients with acute cholecystitis who were unsuitable for cholecystectomy.
Between Mar 2017 and Oct 2017, 22 patients with acute cholecystitis who were unsuitable for cholecystectomy underwent EUS-GBD with the newly designed LAMS. We evaluated the technical and clinical success and the adverse event profiles.
EUS-GBD with newly designed LAMS was technically and clinically successful in 21 of the 22 patients. EUS-GB stenting was performed at urgent setting in 17 patients, while 5 patients, who had undergone initial PTGBD, underwent EUS-GB stenting to remove PTGBD tube. The median procedure time was 11.5 (range 8.8–17.0) min. A late adverse event of stent occlusion developed in one patient. Stent migration was not observed during follow-up (median 318.0 days, range 39.0–398.0 days) and cumulative stent patency rate at 1 year was 95%.
EUS-GBD with newly designed LAMS is feasible and shows acceptable safety profiles for both the urgent drainage of acute cholecystitis and elective internalization following PTGBD in patients with high surgical risk.
KeywordsEndoscopic ultrasound Cholecystitis Gallbladder Drainage Metal stent
Percutaneous transhepatic gallbladder drainage
Endoscopic ultrasound-guided gallbladder drainage
Lumen-apposing metal stent
American Society of Anesthesiologists
DHC were responsible for the conception and design of the study; generation, collection, assembly, analysis, and interpretation of data; and drafting of the manuscript. SSL was responsible for the conception and design of the study; generation, collection, assembly, analysis, and interpretation of data; revision of the manuscript; and approval of the final version of the manuscript. SJJ, JHL, TJS, DHP, SKL, M-HK were responsible for the collection and analysis of data and revision of the manuscript.
Compliance with ethical standards
Drs. Dong Hui Cho, Seok Jung Jo, Jae Hoon Lee, Tae Jun Song, Do Hyun Park, Sung Koo Lee, Myung-Hwan Kim, and Sang Soo Lee have no conflicts of interest or financial ties to disclose.
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