Hybrid procedure combining endoscopic gallbladder lavage and internal drainage with elective cholecystectomy for acute cholecystitis: A prospective pilot study (The <scp>BLADE</scp> study)

Doi, Shinpei; Yasuda, Ichiro; Mabuchi, Masatoshi; Iwata, Koichi; Ando, Nobuhiro; Iwashita, Takuji; Uemura, Shiro; Okuno, Mitsuru; Mukai, Tsuyoshi; Adachi, Seiji; Taniguchi, Koki

doi:10.1111/den.13028

Cited by 24 publications

(25 citation statements)

References 20 publications

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“…Another strategy described in the BLADE study, combining ETGBD and endoscopic gallbladder lavage with elective cholecystectomy, could be considered in patients with acute cholecystitis fit for surgery. 29 Overall technical and clinical success rates in our study were 97.2% and 91.7%, respectively. These results are similar to those reported in a recently published systematic review including 226 patients from nine case series, 30 where technical and clinical success rates were 95.1% and 91.6%.…”

Section: Discussionmentioning

confidence: 47%

“…This combined approach might also be useful in patients with relapsing cholangitis or choledocholithiasis despite previous sphincterotomy or patients with complex malignant biliary obstruction. Another strategy described in the BLADE study, combining ETGBD and endoscopic gallbladder lavage with elective cholecystectomy, could be considered in patients with acute cholecystitis fit for surgery …”

Section: Discussionmentioning

confidence: 99%

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Safety and efficacy of endoscopic ultrasound‐guided gallbladder drainage combined with endoscopic retrograde cholangiopancreatography in the same session

Yuste

García‐Alonso

Sánchez-Ocaña

et al. 2019

Digestive Endoscopy

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Background and Aim: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is an emerging option for acute cholecystitis in non-surgical candidates. Combining endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct stones with EUS-GBD in a single session might become a non-surgical management strategy to comprehensively treat gallstone disease in selected patients. Methods:Single-center retrospective cohort study comparing outcomes between EUS-GBD alone (group A) and single-session ERCP combined with EUS-GBD (group B). Consecutive patients who underwent EUS-GBD with a lumen-apposing metal stent (LAMS) between June 2011 and August 2018 were analyzed. Exclusion criteria were subjects included in randomized clinical trials, patients who had had ERCP within 5 days of EUS-GBD, patients in whom ERCP or EUS-GBD was carried out for salvage of one or the other procedure, and patients who underwent concurrent EUS-guided biliary drainage. Results: One hundred and nine consecutive patients under-went EUS-GBD with LAMS during the study period. Seventy-one patients satisfied the inclusion criteria and 34 patients were in group A and 37 in group B. Baseline characteristics were similar in both groups. There were no significant differences in technical (97.1% vs 97.3%; P = 0.19) and clinical success rates (88.2% vs 94.6%; P = 0.42) of EUS-GBD in group A versus group B. Rate of adverse events was similar in both groups, five (14.7%) in group A versus five (13.5%) in group B. Conclusions:Single-session EUS-GBD combined with ERCP has comparable rates of technical and clinical success to EUS-GBD alone. A combined EUS-GBD and ERCP procedure does not appear to increase adverse events and makes possible comprehensive treatment of gallstone disease by purely endoscopic means.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of endoscopic ultrasound‐guided gallbladder drainage combined with endoscopic retrograde cholangiopancreatography in the same session

Yuste

García‐Alonso

Sánchez-Ocaña

et al. 2019

Digestive Endoscopy

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“…Although ETGBD with ENGBD or EGBS is an effective alternative method when emergency cholecystectomy and PTGBD are considered high risk 1 2 3 4 5 , ETGBD is technically difficult. In the last 10 years, the technical success rate is reported to be 64 % to 96 % 5 6 7 8 9 12 13 14 15 16 17 18 19 20 . ETGBD’s technical difficulty is associated with the inherent complexity of inserting the GW into the gallbladder.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical success rates with ETGBD for acute cholecystitis are reported to be 83 % to 100 % in per-protocol analyses 5 6 7 8 9 12 13 14 15 16 17 18 19 20 21 . It has also been reported that the clinical success rate with ETGBD is roughly 10 % lower than the technical success rates in intention-to-treat analysis because of the accumulation of purulent material, sludge, or gallstones, thus hindering effective drainage 13 22 23 .…”

Section: Discussionmentioning

confidence: 99%

Endoscopic transpapillary gallbladder stenting using a newly designed plastic stent for acute cholecystitis

et al. 2019

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Background and study aims Biliary plastic stents are generally substituted for gallbladder stents in endoscopic transpapillary gallbladder stenting (EGBS), there is no sufficient evidence about what type of plastic stent is suitable. We examined outcomes of EGBS using standard biliary stents and a novel stent for acute cholecystitis and evaluated the efficacy of the novel stent. Patients and methods Seventy patients with acute cholecystitis in whom EGBS was performed were evaluated retrospectively. We performed EGBS in 23 patients using the novel stent (novel stent group) and 47 patients using standard biliary stents (pigtail: 35, straight: 12) (control group). In the two groups, we examined outcomes of EGBS. Results There were no significant differences in patient backgrounds or rates of technical success, clinical success, or early adverse events (AE) between the novel stent group and the control groups. However, rates of late AEs were 4.3 % in the novel stent group (liver abscess: 1) and 40.4 % in the control group (stent migration: 15, recurrence of cholecystitis: 4), indicating a significantly higher rate in the control group (P = 0.004). The rate of stent migration was significantly higher in the control group (P = 0.006). Multivariate analysis identified a straight type stent as the risk factor for stent migration (odds ratio: 8.81, 95 % confidence interval: 1.66 – 46.83). Conclusions The novel stent had significantly lower rates of late AEs and stent migration. Thus, for long-term stent placement, the novel stent was more effective than traditional biliary stents.

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“…6). Finally, we placed a modified 5F, 13-cm single-pigtail plastic stent created by cutting nasobiliary tube 7 (Gadelius Medical Co, Ltd, Tokyo, Japan) into the gallbladder (Fig. 7).…”

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confidence: 99%

Endoscopic transpapillary gallbladder stent placement in the presence of uncovered biliary metal stents using a through-the-mesh technique

et al. 2020

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Hybrid procedure combining endoscopic gallbladder lavage and internal drainage with elective cholecystectomy for acute cholecystitis: A prospective pilot study (The BLADE study)

Abstract: http://www.umin.ac.jp/ctr/index.htm (ID: UMIN-000009680).

Cited by 24 publications

References 20 publications

Safety and efficacy of endoscopic ultrasound‐guided gallbladder drainage combined with endoscopic retrograde cholangiopancreatography in the same session

Safety and efficacy of endoscopic ultrasound‐guided gallbladder drainage combined with endoscopic retrograde cholangiopancreatography in the same session

Endoscopic transpapillary gallbladder stenting using a newly designed plastic stent for acute cholecystitis

Endoscopic transpapillary gallbladder stent placement in the presence of uncovered biliary metal stents using a through-the-mesh technique

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