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DOI: 10.1055/a-2509-7076
EUS-guided gallbladder drainage vs dual stent transpapillary gallbladder drainage for management of acute cholecystitis
Abstract
Background and study aims
Cholecystectomy (CCY) is the standard treatment for acute cholecystitis. For non-surgical patients, percutaneous cholecystostomy tube (PT-GBD) is recommended but is associated with high readmission rates and poor quality of life. Endoscopic gallbladder decompression techniques, including endoscopic transpapillary gallbladder drainage (ET-GBD) and endoscopic ultrasound-guided gallbladder drainage (EUS-GBD), are alternatives. Studies comparing ET-GBD and EUS-GBD have shown EUS-GBD to have superior outcomes. However, these studies assessed ET-GBD mostly via single transcystic stent placement (SSET-GBD). This study aimed to compare outcomes of dual transcystic stents (DSET-GBD) and EUS-GBD in non-surgical candidates with acute cholecystitis.
Patients and methods
A multicenter analysis was conducted on patients who underwent ET-GBD or EUS-GBD between January 2019 and January 2023. Data were extracted from electronic medical records and outcomes including technical success, success, adverse events (AEs), and recurrence rates of cholecystitis were measured.
Results
Of 129 procedures (56 EUS-GBD; 73 ET-GBD), technical success was achieved in 87.5% of EUS-GBD and 86.3% of ET-GBD attempts. Immediate clinical success was achieved in 98.1% for EUS-GBD and 100% for DSET-GBD. AE rates were similar between the groups. Recurrent cholecystitis rates were 5.3% for EUS-GBD and 8.2% for DSET-GBD (P = 0.692).
Conclusions
This study demonstrates that DSET-GBD has similarly low rates of recurrent acute cholecystitis compared with EUS-GBD. DSET-GBD should be considered as an alternative management strategy for management of acute cholecystitis in patients who are unable to undergo CCY.
Publikationsverlauf
Eingereicht: 24. Juni 2024
Angenommen nach Revision: 16. Dezember 2024
Accepted Manuscript online:
02. Januar 2025
Artikel online veröffentlicht:
29. Januar 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
Dhruval Amin, Katherine M. Cooper, Prashanth Rau, Lea Sayegh, Nouran Mostafa, Ikechukwu Achebe, Zachary DeVore, Daniella Gonzalez, Stephanie Stephanie, Jaroslav Zivny, Savant Mehta, Christopher Marshall, Navine Nasser-Ghodsi, Andrew C Storm, Neil B. Marya. EUS-guided gallbladder drainage vs dual stent transpapillary gallbladder drainage for management of acute cholecystitis. Endosc Int Open 2025; 13: a25097076.
DOI: 10.1055/a-2509-7076
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