EUS-guided gallbladder drainage using a lumen-apposing metal stent as rescue treatment for malignant distal biliary obstruction: a large multicenter experience

Binda, Cecilia; Anderloni, Andrea; Fugazza, Alessandro; Amato, Arnaldo; Nucci, Germana de; Redaelli, A.; Mitri, R. Di; Cugia, Luigi; Pollino, Valeria; Macchiarelli, Raffaele; Mangiavillano, Benedetto; Forti, Edoardo; Brancaccio, Mario Luciano; Badas, Roberta; Maida, Marcello; Sinagra, Emanuele; Repici, Alessandro; Fabbri, Carlo; Tarantino, Ilaria

doi:10.1016/j.gie.2023.06.054

Cited by 18 publications

(11 citation statements)

References 33 publications

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“…The stent patency rate at 30 days from the procedure was 82%. Recently, a large retrospective Italian study included 48 EUS-GBD with LAMS, confirming the good technical and clinical results previously reported, with a technical and clinical success of 100% and 81.3%, respectively, and a mean total bilirubin reduction after 2 weeks of 66.5% [78]. The overall clinical success and adverse event rates reported in the meta-analysis are 85% and 13%, respectively [79,80].…”

Section: Eus-gallbladder Drainage As a Rescue Strategy In Malignant B...supporting

confidence: 78%

Endoscopic Gallbladder Drainage: A Comprehensive Review on Indications, Techniques, and Future Perspectives

Troncone,

Amendola,

Moscardelli

et al. 2024

Medicina

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In recent years, therapeutic endoscopy has become a fundamental tool in the management of gallbladder diseases in light of its minimal invasiveness, high clinical efficacy, and good safety profile. Both endoscopic transpapillary gallbladder drainage (TGBD) and endoscopic ultrasound (EUS)-guided gallbladder drainage (EUS-GBD) provide effective internal drainage in patients with acute cholecystitis unfit for cholecystectomy, avoiding the drawbacks of external percutaneous gallbladder drainage (PGBD). The availability of dedicated lumen-apposing metal stents (LAMS) for EUS-guided transluminal interventions contributed to the expansion of endoscopic therapies for acute cholecystitis, making endoscopic gallbladder drainage easier, faster, and hence more widely available. Moreover, EUS-GBD with LAMS opened the possibility of several cholecystoscopy-guided interventions, such as gallstone lithotripsy and clearance. Finally, EUS-GBD has also been proposed as a rescue drainage modality in malignant biliary obstruction after failure of standard techniques, with encouraging results. In this review, we will describe the TBGD and EUS-GBD techniques, and we will discuss the available data on clinical efficacy in different settings in comparison with PGBD. Finally, we will comment on the future perspectives of EUS-GBD, discussing the areas of uncertainty in which new data are more strongly awaited.

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Section: Eus-gallbladder Drainage As a Rescue Strategy In Malignant B...supporting

confidence: 78%

Endoscopic Gallbladder Drainage: A Comprehensive Review on Indications, Techniques, and Future Perspectives

Troncone,

Amendola,

Moscardelli

et al. 2024

Medicina

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“…16 The technical success rate aligns with or surpasses the reported rates using alternative devices, re ecting the e cacy of Hot-SPAXUS. 3,17 The high success rate is likely attributed not only to the simpli ed procedure that eliminates the need for stulous tract dilatation but also to the expertise of the endosonographer. In three cases of intraprocedural AEs leading to technical failure, stent migration into the gallbladder occurred during stent deployment.…”

Section: Discussionmentioning

confidence: 99%

Revolutionizing Outcomes: Endoscopic Ultrasound-guided Gallbladder Drainage Using Innovative Electrocautery Enhanced-Lumen Apposing Metal Stents for High-risk Surgical Patients

Chon,

Lee,

Kim

et al. 2024

Preprint

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This study evaluated the outcomes of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using novel electrocautery-enhanced lumen-apposing metal stents (LAMS) in high-risk patients with acute cholecystitis (AC). Between January 1, 2021, and November 30, 2022, 58 high-risk surgical patients with AC underwent EUS-GBD with the novel electrocautery-enhanced LAMS. The technical success rate was 94.8% (55/58), with one case of duodenal perforation requiring surgery with complete stent migration and two of partial stent migration into the gallbladder. However, the clinical success rate was 100% (55/55). Recurrent AC occurred in 3.6% of the cases (2/55), managed with double pigtail plastic stents alongside the LAMS. Early AEs observed in 1.8% (1/55) due to stent obstruction. Late AEs occurred in 5.4% (3/55), including two cases of cholangitis and one of stent obstruction. For 33 patients followed over 6 months, LAMS maintenance was sustained in 30 cases. Two patients underwent double-pigtail plastic stent replacement after LAMS removal, and one underwent LAMS removal during surgery following tumor stage regression after chemotherapy for cholangiocarcinoma. The novel electrocautery-enhanced LAMS demonstrated high technical and clinical success rates in high-risk surgical patients with AC, maintaining effective gallbladder drainage with AEs during long-term follow-up, thus highlighting its efficacy and safety in challenging patients.

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“…In a large multicenter retrospective analysis by Binda et al [ 25 ], the safety and effectiveness of EUS-GBD using LAMS as a rescue treatment for DMBO in patients who had failed both ERCP and EUS-CDS were evaluated. The study concluded that EUS-GBD with LAMS as a rescue treatment for DMBO showed high rates of technical and clinical success, with an acceptable rate of AEs[ 25 ] (Figures 1D - G ). Please refer to Table 3 for comparative studies on EUS-GBD as a rescue approach.…”

Section: Eus-gbd: a Rescue Optionmentioning

confidence: 99%

Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage

Fugazza,

Khalaf,

Pawlak

et al. 2024

World J Gastroenterol

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This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) as a salvage approach in cases of unsuccessful conventional management. EUS-GBD is a minimally invasive and effective technique for drainage in patients with acute cholecystitis with high risk of surgery. The procedure has demonstrated impressive technical and clinical success rates with low rates of adverse events, making it a safe and effective option for appropriate candidates. Furthermore, EUS-GBD can also serve as a rescue option for patients who have failed endoscopic retrograde cholangiopancreatography or EUS biliary drainage for relief of jaundice in malignant biliary stricture. However, patient selection is critical for the success of EUS-GBD, and proper patient selection and risk assessment are important to ensure the safety and efficacy of the procedure. As the field continues to evolve and mature, ongoing research will further refine our understanding of the benefits and limitations of EUS-GBD, ultimately leading to improved outcomes for patients.

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EUS-guided gallbladder drainage using a lumen-apposing metal stent as rescue treatment for malignant distal biliary obstruction: a large multicenter experience

Cited by 18 publications

References 33 publications

Endoscopic Gallbladder Drainage: A Comprehensive Review on Indications, Techniques, and Future Perspectives

Endoscopic Gallbladder Drainage: A Comprehensive Review on Indications, Techniques, and Future Perspectives

Revolutionizing Outcomes: Endoscopic Ultrasound-guided Gallbladder Drainage Using Innovative Electrocautery Enhanced-Lumen Apposing Metal Stents for High-risk Surgical Patients

Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage

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