THE EFFICACY AND SAFETY OF ENDOSCOPIC TRANS-PAPILLARY GALLBLADDER STENTING TO REPLACE PERCUTANEOUS CHOLECYSTOSTOMY IN POOR SURGICAL CANDIDATES

Aims Endoscopic trans-papillary gallbladder stenting (ETGBS) is a useful alternative to percutaneous cholecystostomy (PC) in patients with acute cholecystitis when cholecystectomy must be delayed or cannot be performed. However, there are few data on the efficacy and safety of ETGBS replacement of PC in patients unfit for cholecystectomy.

Methods This single center retrospective study reviewed data of patients who attempted underwent ETGBS to replace PC between January 2017 and September 2019. Technical success, clinical success, adverse events, and stent patency were evaluated.

Results ETGBS was performed in 43 patients (24 men, mean age 80.7 ± 7.5 years) to replace PC due to high surgical risk. The technical success rate and clinical success rate was 97.6% (42/43) and 92.8% (39/42), respectively. There were three adverse events, post endoscopic retrograde cholangiography related acute pancreatitis in two cases and hematoma around cystic duct in one case. PC was removed after ETGBS in 40 patients at a median of 11.5 days (range, 1–73 days). Median stent patency was 362.5 days (Interquartile range 160.5–483.5 days).

Conclusions ETGBS as a secondary intervention for the purpose of internalizing gallbladder drainage in patients following placement of a PC is safe and effective, and technically feasible. Thus, switching to ETGBS may be considered as viable option in high surgical risk patient with PC.

 

MissingLinkText