Endoscopic Ultrasonography-Guided Gallbladder Drainage as a Treatment Option for Acute Cholecystitis after Metal Stent Placement in Malignant Biliary Strictures.
Acute cholecystitis
Endscopic ultrasonography-guided gallbladder drainage
Percutaneous transhepatic gallbladder aspiration
Percutaneous transhepatic gallbladder drainage
Unresectable malignant biliary stricture
Journal
Clinical endoscopy
ISSN: 2234-2400
Titre abrégé: Clin Endosc
Pays: Korea (South)
ID NLM: 101576886
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
16
10
2018
accepted:
01
01
2019
pubmed:
16
3
2019
medline:
16
3
2019
entrez:
16
3
2019
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND/AIMS
OBJECTIVE
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
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
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.
CONCLUSION
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.
Identifiants
pubmed: 30871312
pii: ce.2018.183
doi: 10.5946/ce.2018.183
pmc: PMC6547349
doi:
Types de publication
Journal Article
Langues
eng
Pagination
262-268Références
AJR Am J Roentgenol. 2001 Apr;176(4):1025-31
pubmed: 11264103
Endoscopy. 2001 Oct;33(10):898-900
pubmed: 11571690
AJR Am J Roentgenol. 2004 Jul;183(1):193-6
pubmed: 15208137
Clin Gastroenterol Hepatol. 2006 Sep;4(9):1148-53
pubmed: 16904950
Gastrointest Endosc. 2007 Apr;65(4):735-7
pubmed: 17141230
Gastrointest Endosc. 2008 Sep;68(3):455-60
pubmed: 18561927
J Hepatobiliary Pancreat Sci. 2011 Mar;18(2):282-6
pubmed: 20652716
Gastroenterology. 2012 Apr;142(4):805-11
pubmed: 22245666
Gastrointest Endosc. 2012 Apr;75(4):870-6
pubmed: 22301347
Gastrointest Endosc. 2013 Feb;77(2):303-8
pubmed: 23206813
J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):81-8
pubmed: 23307009
Gastrointest Endosc Clin N Am. 2013 Apr;23(2):453-9
pubmed: 23540969
Dig Endosc. 2014 Jul;26(4):599-602
pubmed: 24102709
J Am Geriatr Soc. 2014 Feb;62(2):342-6
pubmed: 24521366
Endoscopy. 2014 Aug;46(8):656-61
pubmed: 24977397
J Hepatobiliary Pancreat Sci. 2015 Jan;22(1):35-43
pubmed: 25392972
Gastrointest Endosc. 2015 Dec;82(6):1031-6
pubmed: 25952093
Gut. 2016 Jan;65(1):6-8
pubmed: 26041748
Gastrointest Endosc. 2015 Dec;82(6):1110-5
pubmed: 26142558
Therap Adv Gastroenterol. 2016 Jan;9(1):19-25
pubmed: 26770264
Surg Endosc. 2016 Dec;30(12):5200-5208
pubmed: 27059975
Dig Liver Dis. 2016 Sep;48(9):1054-7
pubmed: 27328985
Gastrointest Endosc. 2017 Feb;85(2):357-364
pubmed: 27566055
Endoscopy. 2017 Feb;49(2):130-138
pubmed: 27875855
J Clin Gastroenterol. 2018 Jan;52(1):79-84
pubmed: 28009687
Clin Gastroenterol Hepatol. 2017 May;15(5):738-745
pubmed: 28043931
World J Gastroenterol. 2017 Jan 28;23(4):661-667
pubmed: 28216973
Gastrointest Endosc. 2017 Oct;86(4):636-643
pubmed: 28259594
Eur J Gastroenterol Hepatol. 2018 Jul;30(7):695-698
pubmed: 29578866
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Am J Clin Oncol. 1982 Dec;5(6):649-55
pubmed: 7165009