Efficacy and safety of Single-Operator cholangioscopy assised endoscopic transpapillary gallbladder drainage in patients with acute cholecystitis

Aims Percutaneous transhepatic gallbladder drainage has been the most frequently performed procedure for acute cholecystitis for patients who are not candidates for cholecystectomy. Endoscopic transpapillary gallbladder drainage (ETGBD) may be another treatment option. However, the success rate of ETGBD is not high because cystic duct cannulation is often difficult with conventional ERCP. Single operator cholangioscopy (SOC) could overcome this limitation because it is possible to directly observe the opening of the cystic duct and insertion the guidewire.

Methods Patients who failed ETGBD with conventional ERCP were included. The technical success rate, clinical success rate, adverse events of SOC assisted ETGBD were evaluated.

Results The technical and clinical success rates by intention-to-treat analysis for SOC-assisted ETGBD were 87.5% (28/32) and 84.3% (27/32), respectively. Adverse events occurred in 9.3% of patients (3/32: mild pancreatitis, n=2; post-endoscopic sphincterotomy bleeding, n=1). All patients were treated with conservative management.

Conclusions SOC-assisted ETGBD was an effective and safety modality in patients with acute cholecystitis who failed with conventional ERCP with acceptable adverse events.

Publication History

Article published online:
27 March 2025