Post-endoscopic retrograde cholangiopancreatography cholecystitis: A review of incidence, risk factors, prevention, and management

Table 1 Strategies for the prevention of post-endoscopic retrograde cholangiopancreatography cholecystitis

Modification of techniques in the high-risk group	Endoscopic techniques
	Modality	Outcome
Aspirating bile before and limiting the volume of contrast injection; avoiding covered and high axial force SEMS; using a multi-hole, fully-covered or uncovered SEMS	ETGBD	Technical success: 58%-75%, PEC: 0%-4%, Adverse event: 0%-26.7%
	EUS-GBD	Technical success: 100%, PEC: 0%, Adverse event: 0%

EUS-GBD: Endoscopic ultrasound-guided gallbladder drainage; ETGBD: Endoscopic transpapillary gallbladder drainage; percutaneous transhepatic gallbladder drainage; PEC: Post endoscopic retrograde cholangiopancreatography cholecystitis; SEMS: Self-expandable metallic stents.

Table 2 Reported outcomes of various options for the treatment of post-endoscopic retrograde cholangiopancreatography cholecystitis

Technique	Avoid in	Technical success (%)	Clinical success (%)	Adverse events (%)	Recurrence (%)
Conservative	Moderate to severe cholangitis	-	96	-	-
PTGBA	Severe cholangitis, tumor involvement of OCD	100	54-90	0-7.1	14.3-36.7
PTGBD	Coagulopathy, ascites	95-100	91-95	0-9	10-33
ETGBD	Complete cystic duct obstruction	75-83.3	90-100	0-16.7	0
EUS-GBD	Coagulopathy	90-100	89-100	8-40	0-38
Cholecystectomy	Critically ill patients	100	100	-	-

EUS-GBD: Endoscopic ultrasound-guided gallbladder drainage; ETGBD: Endoscopic transpapillary gallbladder drainage; OCD: Orifice of the cystic duct; PTGBA: Percutaneous transhepatic gallbladder aspiration; PTGBD: Percutaneous transhepatic gallbladder drainage.