Conversion to EUS-guided internal gallbladder drainage from percutaneous cholecystostomy: A successful case using a novel plastic stent

Hayashi, Yuki; Minaga, Kosuke; Yoshikawa, Tomoe; Ishii, Tatsuya; Matsumoto, Hisakazu; Uenoyama, Yoshito; Yamashita, Yoshihisa

doi:10.1016/j.ajg.2019.05.003

Cited by 3 publications

(2 citation statements)

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“…A few studies have reported the conversion of PC to EUS-GBD as a secondary internal GB drainage approach. [12][13][14][15] The technical success rate of EUS-GBD conversion ranges from 90.5% to 100%, and the clinical success rate ranges from 89.5% to 100%. Additionally, procedure-related complications occurred in 0% to 21.4% of the cases, and the AC recurrence rate was 0% to 28.6%.…”

Section: Discussionmentioning

confidence: 99%

“…3 Many studies have reported that primary ET-GBS and EUS-GBD have high technical and clinical success rates with infrequent procedure-related complications, [4][5][6][7][8][9][10][11] and several recent studies have assessed the conversion of PC to ET-GBS or EUS-GBD in patients at high surgical risk. [12][13][14][15][16] However, no studies have compared endoscopic internalization of percutaneous cholecystostomy (EIPC) and conservative treatment following PC removal. The current study aimed to compare the clinical outcomes of EIPC followed by PC removal and those of conservative treatment following PC removal.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Gallbladder Drainage Conversion versus Conservative Treatment Following Percutaneous Gallbladder Drainage in High-Risk Surgical Patients

Chon

Kim

2023

Gut and Liver

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Background/Aims There are no consensus guidelines for patients with acute cholecystitis undergoing percutaneous cholecystostomy who are unfit for interval cholecystectomy. The current study aimed to compare the clinical outcomes of endoscopic gallbladder drainage, i.e. conversion from percutaneous cholecystostomy (including endoscopic transpapillary gallbladder stenting and endoscopic ultrasound-guided gallbladder drainage), and conservative treatment after percutaneous cholecystostomy tube removal. Methods This retrospective review included patients who underwent percutaneous cholecystostomy for acute cholecystitis between January 2017 and December 2020. Consecutive patients who underwent endoscopic gallbladder drainage or percutaneous cholecystostomy tube removal without interval cholecystectomy were included. Outcome measures included recurrent acute cholecystitis and unplanned readmission due to gallstone-related diseases. Results During the study period, 238 patients were selected (63 underwent endoscopic gallbladder drainage conversion and 175 underwent conservative treatment). Patients who underwent endoscopic gallbladder drainage conversion had lower rates of recurrent acute cholecystitis (3 [4.76%] vs 31 [17.71%], p=0.012) and unplanned readmission due to gallstone-related diseases (6 [9.52%] vs 40 [22.86%], p=0.022) than those who underwent conservative treatment following percutaneous cholecystostomy tube removal. In the univariate and multivariate analyses, calculus cholecystitis (odds ratio, 13.75; 95% confidence interval, 1.83 to 102.83; p=0.011) and conversion of endoscopic gallbladder drainage (odds ratio, 0.23; 95% confidence interval, 0.06 to 0.78; p=0.019) were significant predictive factors for recurrent acute cholecystitis. Conclusions Endoscopic gallbladder drainage conversion led to more favorable outcomes than conservative treatment after percutaneous cholecystostomy tube removal. Therefore, endoscopic gallbladder drainage conversion may be considered a promising treatment option for patients undergoing percutaneous cholecystostomy who are at a high surgical risk.

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Section: Discussionmentioning

confidence: 99%