Aims:
To verify the efficacy, complications and readmissions for the treatment of acute
cholecystitis and choledocholithiasis by performing vesicular drainage through the
endoscopic placement of transpapillary cholecystoduodenal stent during ERCP, in patients
with high surgical risk.
Methods:
Descriptive, retrospective study, obtaining two groups.
Group I: patients presenting with choledocholithiasis and acute cholecystitis, ERCP
is performed, the bile duct is cleaned and a transpapillary cholecystoduodenal drainage
is placed.
Group II: patients with choledocholithiasis and acute cholecystitis, ERCP is performed,
the bile duct is cleaned and a transpapillary cholecystoduodenal drainage is not placed.
Results:
Group I: 12 patients, 58% female, mean age 86 ± 6 years with a follow-up period of
20 ± 18 months. Resolution of acute cholecystitis in 11 (92%) of patients, of which
2 (18%) were re-admitted, one for acute cholecystitis and the other for scheduled
cholecystectomy. No complications derived from the procedure.
Group II: 25 patients, 48% female sex, mean age 81 ± 9 years with a follow-up period
of 22 ± 18 months. Resolution of acute cholecystitis 21 (84%) patients, of whom 10
(48%) were re-admitted, 3 (30%) for acute cholecystitis, 6 (60%) for scheduled cholecystectomy
and 1 (10%) for acute cholangitis. Complications of ERCP: 2 (8%) with upper gastrointestinal
bleeding and 1 (4%) acute pancreatitis.
Conclusions:
The results show that transpapillary cholecystoduodenal drainage presents a high success
with a very low complication rate. So, it should be considered as a therapeutic alternative
in patients with high surgical risk.
