Efficacy of Endoscopic Retrograde Cholecystoendoprosthesis (ERCCE) for Cholecystitis

Tamada, Kiichi; Seki, Hiroaki; Sato, Kouichi; Kano, Tomoyuki; Sugiyama, Shinichi; Ichiyama, M; Wada, Shinsuke; Ohashi, Akiyoshi; Tomiyama, G.; Ueno, Akihisa; Aka, T. Yaman; Kimura, Kayoko

doi:10.1055/s-2007-1010596

Cited by 65 publications

(54 citation statements)

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“…Several investigators have reported that ETGBD is effective and safe for patients with acute cholecystitis (6)(7)(8)17) and that EGBS is one of the promising alternative treatment options (9)(10)(11)(12)(13)(14)(15)(16)(17). In patients with concomitant unresectable cancer, it is important to control infectious diseases, including acute cholecystitis.…”

Section: Discussionmentioning

confidence: 99%

“…Cholecystectomy is generally a safe procedure, but the surgical risk is high in patients with severe medical or surgical comorbidities (3). In such high-risk patients, percutaneous der stenting (EGBS) is a promising alternative treatment option for critically ill patients with symptomatic acute cholecystitis (10)(11)(12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Endoscopic Gallbladder Stenting for Acute Cholecystitis in Patients with Concomitant Unresectable Cancer

et al. 2016

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Objective Endoscopic gallbladder stenting (EGBS) is an alternative treatment option for high-risk surgical patients with acute cholecystitis. However, there are no reports focusing on EGBS in patients with concomitant unresectable cancer. The aim of this study was thus to evaluate EGBS in such patients. Methods Twenty-two consecutive patients with acute cholecystitis and unresectable cancer were enrolled between September 2010 and December 2014. Their median age was 74.5 years (range: 51-95). Thirteen patients were men and nine were women. The primary cancers of the patients were biliary tract cancer (9), pancreas cancer (9), lung cancer (2), gastric cancer (1), and colon cancer (1). The causes of cholecystitis were calculus cholecystitis (7), obstruction by malignant tumor (13), and obstruction by fully covered stent (2). Results EGBS was successfully performed in 17 patients (77.2%). The technical success rates for calculus cholecystitis, obstruction by malignant tumor, and obstruction by fully covered stent were 85.7% (6/7), 69.2% (9/13), and 100% (2/2), respectively. No complications were observed. Percutaneous transhepatic gallbladder drainage was conducted on two patients in whom EGBS had failed and then we performed EGBS by a rendezvous approach. Of the 19 patients in whom we finally deployed EGBS, the median follow-up period was 229 days (range: 14-880 days). A recurrence of acute cholecystitis occurred in three (15.7%) patients 14, 130, and 440 days after EGBS placement. The rates of recurrence of cholecystitis at one and two years were 10.5% and 18.7%, respectively. Conclusion Our study demonstrated that EGBS is a safe and effective method for acute cholecystitis in patients with concomitant unresectable cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Endoscopic Gallbladder Stenting for Acute Cholecystitis in Patients with Concomitant Unresectable Cancer

et al. 2016

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“…[16][17][18][19][20][21][22][23][24] Gallbladder stents have been used to treat acute cholecystitis, 22,24 biliary pain, 24 and subacute and recurrent cholecystitis. 23 Kalloo et al 24 reported excellent results with follow-up as long as 17 months in patients with similar advanced liver disease. Even when luminal patency is not maintained, biliary stents prevent stone impaction in the biliary tree in patients with endoscopically unextractable common bile duct stones, and existing reports in other patients suggest that excellent results may be achieved for up to 5 years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Scattered case reports have suggested that endoscopic gallbladder stenting in high-risk patients may be effective. [20][21][22][23][24] We previously reported our preliminary experience of gallbladder stenting with successful outcomes in three patients. 25 In this report, we describe our prospective investigation evaluating the efficacy of endoscopic stenting of the gallbladder for symptomatic gallbladder disease in patients with ESLD awaiting OLT.…”

confidence: 99%

Endoscopic stenting of the gallbladder for symptomatic gallbladder disease in patients with end-stage liver disease awaiting orthotopic liver transplantation

1999

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Cholecystectomy in patients with advanced cirrhosis is associated with excessive morbidity and mortality. Because open cholecystectomy in patients with Child's class C cirrhosis has a reported mortality rate as high as 83%, symptomatic gallbladder disease in patients awaiting orthotopic liver transplantation (OLT) poses a unique clinical problem. The goal of this study is to determine whether the treatment of symptomatic gallbladder disease with endoscopic stenting of the gallbladder effectively reduces biliary symptoms and complications or the need for cholecystectomy. Thirteen patients with symptomatic gallbladder disease with and without cholelithiasis and advanced cirrhosis who were candidates for OLT underwent placement of a biliary stent from the gallbladder to the duodenum at endoscopic retrograde cholangiography. In each patient, biliary symptoms and complications ceased after stent placement. Seven patients underwent successful OLT 1 to 24 months after the procedure. One patient subsequently became a noncandidate for OLT and died of diabetes complications 3 years after the procedure. Five others are awaiting OLT (6 to 28 months postprocedure). One patient had recurrent pericholecystic fluid collection requiring percutaneous drainage and antibiotic therapy 8 months after the procedure. No patient has had recurrent symptoms, and currently all patients are free of complications. None required surgical intervention of the gallbladder or biliary tree. We conclude that endoscopic stenting of the gallbladder is the preferred treatment for symptomatic gallbladder disease in patients with end-stage liver disease awaiting OLT. This approach is noninvasive, safe, and effective in preventing potential morbidity and mortality.

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“…Stenting of the gallbladder was first described in the early 1990s [5,6]. In a small retrospective series of 23 patients over a 10-year period, our group evaluated its efficacy in cirrhotic patients with biliary colic awaiting liver transplantation [7].…”

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confidence: 99%

Endoscopic Gallbladder Drainage in Medically Inoperable Patients with Symptomatic Cholelithiasis: A Tube to Avoid “Going Down the Tubes”?

Shah

2015

Dig Dis Sci

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Efficacy of Endoscopic Retrograde Cholecystoendoprosthesis (ERCCE) for Cholecystitis

Cited by 65 publications

References 0 publications

Efficacy and Safety of Endoscopic Gallbladder Stenting for Acute Cholecystitis in Patients with Concomitant Unresectable Cancer

Efficacy and Safety of Endoscopic Gallbladder Stenting for Acute Cholecystitis in Patients with Concomitant Unresectable Cancer

Endoscopic stenting of the gallbladder for symptomatic gallbladder disease in patients with end-stage liver disease awaiting orthotopic liver transplantation

Endoscopic Gallbladder Drainage in Medically Inoperable Patients with Symptomatic Cholelithiasis: A Tube to Avoid “Going Down the Tubes”?

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