Safety of EUS-guided gallbladder drainage using a lumen-apposing metal stent in patients requiring anticoagulation

Vozzo, Catherine F.; Simons-Linares, C. Roberto; Saleh, Mohannad Abou; Stevens, Tyler; Chahal, Prabhleen

doi:10.1016/j.vgie.2020.07.009

Cited by 12 publications

(5 citation statements)

References 15 publications

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“…However, the rate of bleeding and perforation was significantly higher for EUS-GBD, compared to PGBD and TGBD (4.3% vs. 2% vs. 1.9%, p =0.02, for bleeding; 3.7% vs. 2% vs. 2%, p = 0.04, for perforation). EUS-GBD should be considered a high-risk procedure in terms of bleeding; therefore, anti-thrombotic drugs should be managed accordingly, even though successful and uneventful EUS-GBD has been anecdotally reported as a last resource in patients with coagulopathy or on anticoagulation therapy [46,47]. On the other hand, PGBD has an increased risk of stent migration/dislodgement and a higher overall adverse events risk according to another recent meta-analysis [40,48].…”

Section: Gallbladder Drainage In Acute Cholecystitis: Percutaneous Tr...mentioning

confidence: 99%

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: Gallbladder Drainage In Acute Cholecystitis: Percutaneous Tr...mentioning

confidence: 99%

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

Troncone,

Amendola,

Moscardelli

et al. 2024

Medicina

View full text Add to dashboard Cite

show abstract

“…2 of 9 one step. Numerous studies have now demonstrated EUS-GBD with LAMS to be safe and effective in poor operative candidates [15][16][17][18]. In a recent systematic review and metaanalysis, EUS-GBD with LAMS demonstrated rates of technical success, clinical success, and adverse events of 94.7%, 92.1%, and 11.7%, respectively [19].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Gallbladder Drainage: Beyond Cholecystitis

Koutlas¹,

Pawa²,

Russell³

et al. 2023

Preprint

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Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is an alternative to surgery for acute cholecystitis (AC) in poor operative candidates. However, the role of EUS-GBD in non-cholecystitis (NC) indications has not been well studied. We compared clinical outcomes of EUS-GBD for AC and NC indications. Consecutive patients undergoing EUS-GBD for all indications at a single center were retrospectively analyzed. Fifty-one patients underwent EUS-GBD during the study period. Thirty-nine (76%) patients had AC while 12 (24%) had NC indications. NC indications included malignant biliary obstruction (n = 8), symptomatic cholelithiasis (n = 1), gallstone pancreatitis (n = 1), choledocholithiasis (n = 1), and Mirizzi’s syndrome (n = 1). Technical success was noted in 92% (36/39) for AC and 92% (11/12) for NC (p &gt; 0.99). Clinical success rate was 94% and 100%, respectively (p &gt; 0.99). There were 4 adverse events in the AC group and 3 in the NC group (p = 0.62). Procedure duration (median 43 vs 45 minutes, p = 0.37), post-procedure length of stay (median 3 vs 3 days, p = 0.97), and total gallbladder related procedures (median 2 vs 2, p = 0.59) were similar. EUS-GBD for NC indications is similarly safe and effective as EUS-GBD in AC.

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“…The application of LAMS for EUS-GBD has drastically simplified the procedure as stent insertion can be performed in just one step. Numerous studies have now demonstrated EUS-GBD with LAMS to be safe and effective in poor operative candidates [15][16][17][18]. In a recent systematic review and meta-analysis, EUS-GBD with LAMS demonstrated rates of technical success, clinical success, and adverse events of 94.7%, 92.1%, and 11.7%, respectively [19].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Gallbladder Drainage: Beyond Cholecystitis

et al. 2023

View full text Add to dashboard Cite

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is an alternative to surgery for acute cholecystitis (AC) in poor operative candidates. However, the role of EUS-GBD in non-cholecystitis (NC) indications has not been well studied. We compared the clinical outcomes of EUS-GBD for AC and NC indications. Consecutive patients undergoing EUS-GBD for all indications at a single center were retrospectively analyzed. Fifty-one patients underwent EUS-GBD during the study period. Thirty-nine (76%) patients had AC while 12 (24%) had NC indications. NC indications included malignant biliary obstruction (n = 8), symptomatic cholelithiasis (n = 1), gallstone pancreatitis (n = 1), choledocholithiasis (n = 1), and Mirizzi’s syndrome (n = 1). Technical success was noted in 92% (36/39) for AC and 92% (11/12) for NC (p > 0.99). The clinical success rate was 94% and 100%, respectively (p > 0.99). There were four adverse events in the AC group and 3 in the NC group (p = 0.33). Procedure duration (median 43 vs. 45 min, p = 0.37), post-procedure length of stay (median 3 vs. 3 days, p = 0.97), and total gallbladder-related procedures (median 2 vs. 2, p = 0.59) were similar. EUS-GBD for NC indications is similarly safe and effective as EUS-GBD in AC.

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Safety of EUS-guided gallbladder drainage using a lumen-apposing metal stent in patients requiring anticoagulation

Cited by 12 publications

References 15 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

Endoscopic Ultrasound-Guided Gallbladder Drainage: Beyond Cholecystitis

Endoscopic Ultrasound-Guided Gallbladder Drainage: Beyond Cholecystitis

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