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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(09): E1386-E1390
DOI: 10.1055/a-1500-8028
Original article

Endoscopic transpapillary gallbladder stenting to prevent acute cholecystitis in patients receiving fully covered self-expandable metal stents for benign biliary stricture

Morgan Wong
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of New Mexico, New Mexico, United States
,
Sergio A. Sánchez-Luna
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of New Mexico, New Mexico, United States
,
Tarun Rustagi
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of New Mexico, New Mexico, United States
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Endoscopic transpapillary gallbladder stenting to prevent acute cholecystitis in patients receiving fully covered self-expandable metal stents for benign biliary strictureEndosc Int Open 2021; 09(09): C9-C9
DOI: 10.1055/a-1627-4763

Abstract

Background and study aims Fully covered self-expanding metal stents (FCSEMS) are being increasingly used for benign biliary strictures (BBS); however, they are associated with risk of acute cholecystitis. Prophylactic endoscopic transpapillary gallbladder stenting (ETPGBS) can facilitate continuous gallbladder drainage and prevent acute cholecystitis from occlusion of cystic duct orifice by the FCSEMS. The aim of this study was to assess the technical feasibility, efficacy, and safety of ETPGBS to prevent acute cholecystitis in patients receiving FCSEMS for BBS.

Patients and methods This was a retrospective analysis of a prospectively collected database at a single center of all patients who underwent prophylactic ETPGBS with FCSEMS for BBS between December 1, 2016 and November 30, 2020.

Results A total of 71 ETPGBS were placed during the study period. Sixteen patients (mean age: 66.4 ± 19.8 years; 81 % male) underwent ETPGBS prior to biliary FCSEMS during the same endoscopic session. FCSEMS were left in place (stent dwell time) for a median of 173 days (range: 69–473; mean 196 ± 121) with resolution of BBS and successful removal of ETPGBS and FCSEMS in 12 patients. There was significant improvement in total bilirubin level (5.25 ± 5.53 vs 0.94 ± 0.85 gm/dL; P = 0.008). No episodes of acute cholecystitis or any other post-procedural complications were noted during the median follow-up of 337 days (range: 150–856; mean 394 ± 236).

Conclusions ETPGBS prevented stent-related acute cholecystitis with continued efficacy of FCSEMS for BBS.



Publication History

Received: 27 December 2020

Accepted: 31 March 2021

Article published online:
23 August 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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