EUS-Guided Gallbladder Drainage Using A Lumen-Apposing Metal Stent for Acute Cholecystitis: Results of A Multicenter Study

C Binda; A Anderloni; E Forti; P Fusaroli; R Macchiarelli; M Manno; A Fugazza; A Redaelli; G Aragona; M Lovera; T Togliani; E Armellini; A Amato; ML Brancaccio; R Badas; N Leone; G de Nucci; B Mangiavillano; M Sbrancia; V Pollino; M Maida; E Sinagra; A Repici; C Fabbri; I Tarantino

doi:10.1055/s-0041-1724424

Endoscopy, Inhaltsverzeichnis

Endoscopy 2021; 53(S 01): S68
DOI: 10.1055/s-0041-1724424

Abstracts | ESGE Days

ESGE Days 2021 Oral presentations

Saturday, 27 March 2021 09:00 – 09:45 EUS for drainage of infected collections Room 6

EUS-Guided Gallbladder Drainage Using A Lumen-Apposing Metal Stent for Acute Cholecystitis: Results of A Multicenter Study

C Binda

¹AUSL Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Forlì-Cesena, Italy

,

A Anderloni

²Humanitas Clinical and Research Center - IRCCS, Digestive Endoscopy Unit, Rozzano (MI), Italy

,

E Forti

³Ospedale Ca’ Granda Niguarda, Digestive and Interventional Endoscopy Unit, Milano, Italy

,

P Fusaroli

⁴University of Bologna, Gastroenterology Unit, Hospital of Imola (BO), Imola (BO), Italy

,

R Macchiarelli

⁵A.O.U.S. Policlinico S.Maria alle Scotte, Gastroenterology Unit, Siena, Italy

,

M Manno

⁶Azienda USL di Modena, UOSD Gastroenterologia ed Endoscopia Digestiva, Rete Gastroenterologica Provinciale, Modena, Italy

,

A Fugazza

²Humanitas Clinical and Research Center - IRCCS, Digestive Endoscopy Unit, Rozzano (MI), Italy

,

A Redaelli

⁷San Gerardo Hospital, Endoscopy Unit, Monza, Italy

,

G Aragona

⁸Guglielmo da Saliceto Hospital, Gastroenterology and Hepatology Unit, Piacenza, Italy

,

M Lovera

⁹Fondazione Poliambulanza Istituto Ospedaliero, Digestive Endoscopy Unit, Brescia, Italy

,

T Togliani

¹⁰ASST Carlo Poma, Gastroenterology and Endoscopy Unit, Mantova, Italy

,

E Armellini

¹¹ASST Bergamo Est, Digestive Endoscopy Unit, Seriate, Bergamo, Italy

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A Amato

¹²Valduce Hospital, Department of Gastroenterology, Como, Italy

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ML Brancaccio

¹³S. Maria delle Croci Hospital, Division of Gastroenterology, Ravenna, Italy

,

R Badas

¹⁴University Hospital, Digestive Endoscopy Unit, Cagliari, Italy

,

N Leone

¹⁵Humanitas Gradenigo, Digestive Endoscopy Unit, Torino, Italy

,

G de Nucci

¹⁶ASST Rhodense, Gastroenterology and Endoscopy Unit, Garbagnate Milanese (MI), Italy

,

B Mangiavillano

¹⁷Humanitas - Mater Domini, Gastrointestinal Endoscopy Unit, Castellanza, Italy

,

M Sbrancia

¹AUSL Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Forlì-Cesena, Italy

,

V Pollino

¹⁸S. Michele Hospital, Digestive Endoscopy Unit, Cagliari, Italy

,

M Maida

¹⁹S. Elia-Raimondi Hospital, Gastroenterology and Endoscopy Unit, Caltanissetta, Italy

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E Sinagra

²⁰Fondazione Istituto G. Giglio, Gastroenterology and Endoscopy Unit, Cefalù, Italy

,

A Repici

²Humanitas Clinical and Research Center - IRCCS, Digestive Endoscopy Unit, Rozzano (MI), Italy

²¹Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milano, Italy

,

C Fabbri

¹AUSL Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Forlì-Cesena, Italy

,

I Tarantino

²²IRCCS-ISMETT, Endoscopy Service, Department of Diagnostic and Therapeutic Services, Palermo, Italy

› Institutsangaben

Abstract

Volltext

Aims The aim of the study is the evaluation of the effectiveness and safety of endoscopic ultrasound guided gallbladder drainage (EUS-GBD) using lumen apposing metal stents (LAMS) for acute cholecystitis (AC) in a large cohort of patients at high-risk for cholecystectomy.

Methods This is a multicenter, retrospective study including EUS-guided GBD using LAMS performed in fragile patients with AC in 19 Italian Centers from June 2014 to July 2020. Primary outcomes were technical and clinical success, secondary outcome was adverse events (AEs) rate.

Results A total of 116 patients (48.3 % female) were included, with a mean age of 82.7 ± 11 years. The mean gallbladder major axis was 71.2 ± 35.8 mm, while the mean width was 59.4 ± 34 mm. LAMS were placed transgastric in 44.8 % of cases, transduodenal in 53.3 % and transjejunal in 1.7 % in patient with altered anatomy. Technical and clinical success were achieved in 93.1 % and 87.1 % of cases respectively. In particular, white blood cell (WBC) count, C reactive protein (CRP), total and direct bilirubin levels were statistically significant reduced (p<0.05) after two weeks. The mean procedure time was 24.5 minutes. Mean hospital stay was 11.2 ± 9 days. The mean follow-up was 186.4 days. AEs occurred in 12/116 pts (10.3 %): 8/12 were intraprocedural, while 1 was classified as early (< 15 days) and 3 as delayed (> 15 days). According to ASGE lexicon, 2 (16.7 %) were mild, 3 (25 %) were moderate, while 7 (58.3 %) were severe.

Conclusions Our study shows that EUS-GBD had high technical and clinical success rates in a large cohort of fragile patients. Although the not negligible rate of AEs, EUS-guided GBD should be considered an effective option of treatment in inoperable patients.

Citation: Binda C, Anderloni A, Forti E et al. OP167 EUS-GUIDED GALLBLADDER DRAINAGE USING A LUMEN-APPOSING METAL STENT FOR ACUTE CHOLECYSTITIS: RESULTS OF A MULTICENTER STUDY. Endoscopy 2021; 53: S68.