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Endoscopic Ultrasound-Guided Naso-gallbladder Drainage Using a Dedicated Catheter for Acute Cholecystitis After Transpapillary Metal Stent Placement for Malignant Biliary Obstruction

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Abstract

Background

Acute cholecystitis is a significant adverse event after self-expandable metal stent (SEMS) placement for malignant biliary obstruction (MBO); however, no appropriate treatment strategy has been established for its management.

Aims

This study aimed to examine the feasibility and utility of endoscopic ultrasound-guided naso-gallbladder drainage (EUS-NGBD) for the management of acute cholecystitis occurring after SEMS placement.

Methods

This retrospective study investigated consecutive patients with acute cholecystitis after SEMS placement for unresectable MBO, in whom EUS-NGBD was attempted. The study outcomes included technical success, clinical success, procedure time, adverse event, and cholecystitis recurrence, associated with the procedure.

Results

During the study period, EUS-NGBD was performed for SEMS-related acute cholecystitis in 30 patients with MBO. The technical and clinical success rates were 96.7% (29/30) and 96.6% (28/29), respectively. The median procedure time was 15 min, and rate of procedure-related adverse event was 3.3% (1/30). The median duration from the procedure to tube removal was 9 days. No adverse events were observed after removal. The median hospitalization duration after the procedure was 14 days, and the median duration to the (re-)start of chemotherapy from cholecystitis onset was 13 days. The median overall survival after EUS-NGBD was 123 days, and the rate of cholecystitis recurrence until death was 4.2% (1/28).

Conclusions

This study demonstrated that EUS-NGBD possesses good technical and clinical feasibility with an acceptable adverse event rates and short hospitalization and chemotherapy withdrawal period. Therefore, EUS-NGBD may be a good option for the treatment of SEMS-related cholecystitis in patients with MBO.

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Acknowledgments

None.

Funding

This study did not receive funding from any external source.

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Authors and Affiliations

  1. Department of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan

    Tadahisa Inoue, Rena Kitano, Mayu Ibusuki, Kazumasa Sakamoto, Satoshi Kimoto, Yuji Kobayashi, Yoshio Sumida, Yukiomi Nakade, Kiyoaki Ito & Masashi Yoneda

Authors
  1. Tadahisa Inoue
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  2. Rena Kitano
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  3. Mayu Ibusuki
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  4. Kazumasa Sakamoto
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  5. Satoshi Kimoto
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  6. Yuji Kobayashi
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  7. Yoshio Sumida
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  8. Yukiomi Nakade
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  9. Kiyoaki Ito
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  10. Masashi Yoneda
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Contributions

TI: Conception and design; data acquisition, analysis, and interpretation; and drafting and revision of the manuscript. RK, MI, KS, SK, YK, YS, YN, KI, and MY: Data interpretation and revision of the manuscript.

Corresponding author

Correspondence to Tadahisa Inoue.

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Conflict of interest

The authors declare no conflict of interests relevant to this study.

Ethical approval

The institutional review board of Aichi Medical University Hospital approved this study (Approval number: 2022-234), which was conducted in accordance with the principles of the Declaration of Helsinki. All patients provided written informed consent for the procedure and were offered the option to opt out of the study if they did not want their data to be published.

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Inoue, T., Kitano, R., Ibusuki, M. et al. Endoscopic Ultrasound-Guided Naso-gallbladder Drainage Using a Dedicated Catheter for Acute Cholecystitis After Transpapillary Metal Stent Placement for Malignant Biliary Obstruction. Dig Dis Sci 68, 4449–4455 (2023). https://doi.org/10.1007/s10620-023-08135-5

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  • DOI: https://doi.org/10.1007/s10620-023-08135-5

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