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

Kazunari Nakahara; Yosuke Michikawa; Ryo Morita; Keigo Suetani; Nozomi Morita; Junya Sato; Kensuke Tsuji; Hiroki Ikeda; Kotaro Matsunaga; Tsunamasa Watanabe; Nobuyuki Matsumoto; Shinjiro Kobayashi; Takehito Otsubo; Fumio Itoh

doi:10.1055/a-0747-5668

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(09): E1105-E1114
DOI: 10.1055/a-0747-5668

Original article

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

Kazunari Nakahara

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Yosuke Michikawa

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Ryo Morita

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Keigo Suetani

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Nozomi Morita

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Junya Sato

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Kensuke Tsuji

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Hiroki Ikeda

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Kotaro Matsunaga

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Tsunamasa Watanabe

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Nobuyuki Matsumoto

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

,

Shinjiro Kobayashi

²Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, Kawasaki, Japan

,

Takehito Otsubo

²Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, Kawasaki, Japan

,

Fumio Itoh

¹Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan

› Author Affiliations

Abstract

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.

Full Text

References

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