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.
