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Niiya F, Tamai N, Yamawaki M, Noda J, Azami T, Takano Y, Nishimoto F, Nagahama M. Benefits of endoscopic gallbladder stenting following percutaneous transhepatic gallbladder drainage. World J Gastrointest Surg 2024; 16:2902-2909. [PMID: 39351569 PMCID: PMC11438794 DOI: 10.4240/wjgs.v16.i9.2902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/10/2024] [Accepted: 08/05/2024] [Indexed: 09/18/2024] Open
Abstract
BACKGROUND Endoscopic transpapillary gallbladder drainage is challenging because of the complexity of the procedure and high incidence of adverse events (AEs). To overcome these problems, endoscopic gallbladder stenting (EGBS) after percutaneous transhepatic gallbladder drainage (PTGBD) can be effective, as it mitigates inflammation and adhesion. AIM To examine the benefits of EGBS after PTGBD to assess its efficacy and impact on AEs. METHODS We retrospectively analyzed data from 35 patients who underwent EGBS after PTGBD at a single center between January 2016 and December 2023. The primary outcomes were technical success and AEs, and the rate of recurrent cholecystitis was evaluated. In addition, the reasons for the failure of the procedure were identified. RESULTS Among the 35 patients, the technical success rate was 77.1% and the final contrast of the cystic duct was successful in 97.1% of patients. The incidence of early AEs was relatively low (11.4%), with no instances of cystic duct perforation. The rate of recurrent cholecystitis was 3.7%, and no other biliary events were observed. CONCLUSION EGBS after PTGBD may be significantly beneficial, with a substantial success rate and minimal AEs in both short- and long-term follow-ups.
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Affiliation(s)
- Fumitaka Niiya
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Kanagawa, Japan
| | - Naoki Tamai
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Kanagawa, Japan
| | - Masataka Yamawaki
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Kanagawa, Japan
| | - Jun Noda
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Kanagawa, Japan
| | - Tetsushi Azami
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Kanagawa, Japan
| | - Yuichi Takano
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Kanagawa, Japan
| | - Fumiya Nishimoto
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Kanagawa, Japan
| | - Masatsugu Nagahama
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Kanagawa, Japan
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Suzuki K, Naito H, Naito E, Sasaki T, Yoshikawa Y, Omagari K, Yoshitake N, Koike T, Hashimoto T, Tamura A. Evaluation of the Validity of Endoscopic Transpapillary Gallbladder Drainage for Acute Cholecystitis Based on the Tokyo Guidelines 2018. J Clin Gastroenterol 2024; 58:419-425. [PMID: 37224282 PMCID: PMC10919268 DOI: 10.1097/mcg.0000000000001866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 04/18/2023] [Indexed: 05/26/2023]
Abstract
GOALS We evaluated the validity of endoscopic transpapillary gallbladder drainage (ETGBD) as a bridging therapy prior to elective Lap-C for the patients with acute cholecystitis (AC). BACKGROUND The Tokyo Guidelines 2018 recommend early laparoscopic cholecystectomy (Lap-C) for patients with AC, however, some patients require the preoperative drainage because of inadequate for early Lap-C du to background and comorbidities. STUDY We performed a retrospective cohort analysis using data from our hospital records from 2018-2021. In total, 71 cases of 61 patients with AC underwent ETGBD. RESULTS The technical success rate was 85.9%. Patients in the failure group had more complicated branching of the cystic duct. The length of time until feeding was started and until WBC levels normalized, and the length of hospital stay were significantly shorter in the success group. The median waiting period for surgery was 39 days in the ETGBD success cases. The median operating time, amount of bleeding, and length of postoperative hospital stay were 134 min, 83.2g, and 4 days, respectively. In patients who underwent Lap-C, the waiting period for surgery and the operating time were similar between the ETGBD success and failure groups. However, the temporary discharge period after drainage and the length of postoperative hospital stay were significantly longer in the patients with ETGBD failure. CONCLUSIONS Our study revealed that ETGBD has equivalent efficacy prior to elective Lap-C despite some challenges that lower its success rate. Preoperativ ETGBD can improve patient quality of life by eliminating the need for a drainage tube.
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Affiliation(s)
- Keiichi Suzuki
- Department of Surgery, National Hospital Organization, Tochigi Medical Center
| | - Hirofumi Naito
- Department of Gastroenterology, National Hospital Organization, Tochigi Medical Center, Tochigi, Japan
| | - Eri Naito
- Department of Gastroenterology, National Hospital Organization, Tochigi Medical Center, Tochigi, Japan
| | - Taketo Sasaki
- Department of Surgery, National Hospital Organization, Tochigi Medical Center
| | - Yusuke Yoshikawa
- Department of Surgery, National Hospital Organization, Tochigi Medical Center
| | - Kenshi Omagari
- Department of Surgery, National Hospital Organization, Tochigi Medical Center
| | - Naoto Yoshitake
- Department of Gastroenterology, National Hospital Organization, Tochigi Medical Center, Tochigi, Japan
| | - Takero Koike
- Department of Gastroenterology, National Hospital Organization, Tochigi Medical Center, Tochigi, Japan
| | - Takeo Hashimoto
- Department of Surgery, National Hospital Organization, Tochigi Medical Center
| | - Akihiko Tamura
- Department of Surgery, National Hospital Organization, Tochigi Medical Center
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Hirakawa N, Yamamoto K, Sofuni A, Tsuchiya T, Ishii K, Tanaka R, Tonozuka R, Mukai S, Nagai K, Matsunami Y, Kojima H, Minami H, Nakatsubo R, Asano K, Itoi T. Factors predicting technical failure of endoscopic transpapillary gallbladder drainage for acute cholecystitis. DEN OPEN 2024; 4:e308. [PMID: 37915764 PMCID: PMC10616688 DOI: 10.1002/deo2.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/12/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023]
Abstract
Objectives Endoscopic transpapillary gallbladder drainage (ETGBD) is a highly technical procedure, but few studies have evaluated factors that predict its technical success. Therefore, in this study, we sought to identify predictors of technically successful ETGBD. Methods One hundred and eighty-two patients who underwent ETGBD for acute cholecystitis at our hospital were retrospectively investigated. Factors associated with technical failure were identified by focusing on clinical characteristics, anatomical features (direction of the cystic duct branch and course of the cystic duct), and procedural factors (cystic duct and gallbladder with or without contrast and cystic duct injury). Results The technical success rate was 84.6% (154/182) and the clinical success rate was 96.1% (148/154). The adverse event rate was 11.0% (20/182; cystic duct injury in 13 patients, pancreatitis in six, and liver abscess in one. Univariate and multivariate analyses identified the right cranial direction and spiral-type course of the cystic duct to be significant anatomical features and cystic duct injury to be a significant procedural feature contributing to the technical failure of ETGBD. Conclusions ETGBD is a highly practical procedure for patients with acute cholecystitis. However, difficulty is encountered in some cases because of anatomical and procedural factors. Our results suggest that ETGBD may be difficult and thus should not be performed in cases with the right cranial direction or spiral-type course of the cystic duct or those with cystic duct injury.
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Affiliation(s)
- Noriyuki Hirakawa
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Kenjiro Yamamoto
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Atsushi Sofuni
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Takayoshi Tsuchiya
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Kentaro Ishii
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Reina Tanaka
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Ryosuke Tonozuka
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Shuntaro Mukai
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Kazumasa Nagai
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Yukitoshi Matsunami
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Hiroyuki Kojima
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Hirohito Minami
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Ryosuke Nakatsubo
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Kyoko Asano
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Takao Itoi
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
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Sato J, Nakahara K, Michikawa Y, Morita R, Suetani K, Sekine A, Igarashi Y, Kobayashi S, Otsubo T, Itoh F. Clinical outcomes and predictors of technical failure of endoscopic transpapillary gallbladder drainage in acute cholecystitis. Scand J Gastroenterol 2023; 58:286-290. [PMID: 36069161 DOI: 10.1080/00365521.2022.2118554] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Endoscopic transpapillary gallbladder drainage (ETGBD) has been performed as an alternative therapy against cholecystectomy in patients with acute cholecystitis. To date, few studies have reported the safety, efficacy, and factors affecting ETGBD. We evaluated the clinical outcomes and predictors of technical failure of ETGBD. METHODS Patients with acute cholecystitis who underwent ETGBD were retrospectively reviewed, and consecutive patients were included in the study. The technical success rate, clinical success rate, adverse events, and the predictors associated with the technical failure of ETGBD were investigated. RESULTS A total of 242 patients were enrolled in the study. The technical success rate of ETGBD and clinical success rate of technically successful ETGBD cases were 87% and 93%, respectively. We experienced cystic duct injury in 24 patients as an ETGBD-related adverse event, and pancreatitis in 12 patients as an endoscopic retrograde cholangiopancreatography-related adverse event. Multivariate analysis indicated that cystic duct injury was the independent predictor associated with the technical failure of ETGBD (odds ratio, 11; 95% confidence interval, 3.9-29; p < 0.001). CONCLUSIONS ETGBD was a safe and effective treatment method for acute cholecystitis with acceptable adverse events. There was no predictor based on the information from patient characteristics; however, cystic duct injury was associated with the technical failure of ETGBD.
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Affiliation(s)
- Junya Sato
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kazunari Nakahara
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yosuke Michikawa
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Ryo Morita
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Keigo Suetani
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Akihiro Sekine
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yosuke Igarashi
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Shinjiro Kobayashi
- Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Takehito Otsubo
- Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Fumio Itoh
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
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Garg S, Dutta U, Chaluvashetty SB, Kumar KH, Kalra N, Sahni D, Aggarwal A. The anatomy of the cystic duct and its association with cholelithiasis: MR Cholangiopancreatographic study. Clin Anat 2022; 35:847-854. [PMID: 35316537 DOI: 10.1002/ca.23856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/17/2022] [Accepted: 03/11/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The aims of this article are to detail the anatomy of the cystic duct in patients with and without gallstones as it relates to maneuvering of the duct during endoscopic transpapillary gallbladder cannulation, and to elucidate its role in the dynamics of bile flow during gallbladder contraction. MATERIAL AND METHODS One hundred MRCPs were retrieved from the prospectively maintained radiology data system to assess the configuration of the cystic duct and its confluence vis-a-vis the main biliary duct. RESULTS The configuration of the cystic duct was broadly classified into four types: Angular (44%), Linear (40%), Spiral (11%) and Complex (5%). The level of emergence of the cystic duct from the bile duct was proximal in 29%, middle in 49% and distal in 20%. Its direction from the bile duct was to the right and angled upward in 69%, right and angled downward in 15%, left and angled upward in 13%, and left and angled downward in 1%. Its orifice was on the lateral surface of the bile duct in 50%, posterior in 19%, anterior in 15% and medial in 14%. In two cases, the cystic duct opened directly into the duodenum. Tortuous cystic ducts and non-lateral unions with the bile duct were significantly more prevalent in gallstone cases than the non-gallstone group (p=0.02). CONCLUSIONS The present study details the spatial anatomy of the cystic duct vis a vis the main biliary duct. This has not been well investigated to date but has become increasingly relevant with the advent of recent gallbladder interventions.
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Affiliation(s)
- Shallu Garg
- Department of Anatomy, St. John's Medical College affiliated to RGUHS, Bengaluru, India
| | - Usha Dutta
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sreedhara B Chaluvashetty
- Department of Radio diagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - K Hemanth Kumar
- Department of Gastrointestinal Surgery, Manipal hospital, Bengaluru, India
| | - Naveen Kalra
- Department of Radio diagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Daisy Sahni
- Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anjali Aggarwal
- Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Park SW, Lee SS. Current status of endoscopic management of cholecystitis. Dig Endosc 2022; 34:439-450. [PMID: 34275173 DOI: 10.1111/den.14083] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/05/2021] [Accepted: 07/15/2021] [Indexed: 12/13/2022]
Abstract
Laparoscopic cholecystectomy remains the standard treatment for acute cholecystitis (AC) although it is always not suitable for patients who are poor candidates for surgery. Recently, endoscopic gallbladder (GB) drainage was found to be a potentially revolutionary alternative for cholecystectomy for the control of symptoms, definitive treatment, or bridging therapy until surgery is possible. Two endoscopic methods have been established using either the trans-mural or trans-papillary drainage approach. Endoscopic ultrasound-guided GB drainage (EUS-GBD; trans-mural approach) is a novel technique that allows stent placement between the GB and duodenum or stomach via fistula track, effectively enabling GB drainage. For endoscopic trans-papillary GB drainage (ETGBD; trans-papillary approach), attempts of selective cannulation to the cystic duct should be made to place the stent in the same manner as an endoscopic retrograde cholangiopancreatography. In comparison, EUS-GBD has higher clinical success and lower recurrence rates than ETGBD due to the use of larger-caliber stents, which allow for effective drainage when performed by skilled practitioners at high-volume centers. Advantages of ETGBD over EUS-GBD include more affordable costs and physiologic drainage, which preserves naive anatomy for possible future cholecystectomy. Although the field of endoscopic treatment for AC is rapidly advancing, important questions regarding which method improves clinical outcomes and safety more effectively remain unaddressed. Herein, the current status of endoscopic treatment for AC, including a technical review on clinical outcomes, adverse events, and advantages and disadvantages of each technique are reviewed, as well as other future prospects.
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Affiliation(s)
- Se Woo Park
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong-si, Korea
| | - Sang Soo Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Nakahara K, Sato J, Morita R, Michikawa Y, Suetani K, Igarashi Y, Sekine A, Kobayashi S, Otsubo T, Itoh F. Incidence and management of cystic duct perforation during endoscopic transpapillary gallbladder drainage for acute cholecystitis. Dig Endosc 2022; 34:207-214. [PMID: 33600001 DOI: 10.1111/den.13959] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/05/2021] [Accepted: 02/14/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIM Evidence regarding the incidence and clinical outcome of cystic duct perforation (CDP) during endoscopic transpapillary gallbladder drainage (ETGBD) is inadequate. The present study aimed to evaluate the incidence and management of CDP during ETGBD. METHODS Between March 2011 and December 2019, 249 patients underwent initial ETGBD for acute cholecystitis. The incidence of CDP was retrospectively examined and the outcomes between the CDP and non-CDP groups were compared. RESULTS CDP during ETGBD occurred in 23 (9.2%) of 249 patients (caused by guidewire in 15 and cannula in 8). ETGBD was successful in 10 patients following CDP. In 13 patients who failed ETGBD, 11 underwent bile duct drainage during the same session; nine patients underwent gallbladder decompression by other methods, such as percutaneous drainage. Clinical resolution for acute cholecystitis was achieved in 20 patients, and no bile peritonitis was noted. ETGBD technical success rates (45.3% vs. 91.2%, p < 0.001), ETGBD procedure times (66.5 vs. 54.8 min, p = 0.041), and hospitalization periods (24.5 vs. 18.7 days, p = 0.028) were significantly inferior in the CDP group (n = 23) compared with the non-CDP group (n = 216). There were no differences in clinical success and adverse events other than CDP between both groups. CONCLUSIONS Cystic duct perforation reduced the ETGBD technical success rate. However, even in patients with cystic duct perforation, an improvement of acute cholecystitis was achieved by subsequent successful ETGBD or additional procedures, such as percutaneous drainage.
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Affiliation(s)
- Kazunari Nakahara
- Departments of, Department of, Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Junya Sato
- Departments of, Department of, Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Ryo Morita
- Departments of, Department of, Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yosuke Michikawa
- Departments of, Department of, Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Keigo Suetani
- Departments of, Department of, Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yosuke Igarashi
- Departments of, Department of, Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Akihiro Sekine
- Departments of, Department of, Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Shinjiro Kobayashi
- Department of, Gastroenterogical and General Surgery, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Takehito Otsubo
- Department of, Gastroenterogical and General Surgery, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Fumio Itoh
- Departments of, Department of, Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kanagawa, Japan
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Takano Y, Noda J, Yamawaki M, Azami T, Kobayashi T, Niiya F, Maruoka N, Nagahama M. Endoscopic Transpapillary Gallbladder Drainage in a Patient with Billroth-II Reconstruction. Intern Med 2021; 60:2613-2615. [PMID: 33678750 PMCID: PMC8429281 DOI: 10.2169/internalmedicine.6964-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Endoscopic transpapillary gallbladder drainage (ETGBD) is an established procedure and is listed in the Tokyo guidelines 2018. Although there are many reports of ETGBD in normal anatomy cases, it is rarely performed for patients with a surgically altered anatomy. We herein report the case of a patient who underwent ETGBD with Billroth-II reconstruction. ETGBD could be an effective treatment option even for patients with a surgically altered anatomy.
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Affiliation(s)
- Yuichi Takano
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
| | - Jun Noda
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
| | - Masataka Yamawaki
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
| | - Tetsushi Azami
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
| | - Takahiro Kobayashi
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
| | - Fumitaka Niiya
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
| | - Naotaka Maruoka
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
| | - Masatsugu Nagahama
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
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The Influence of Pre-Procedural Imaging and Cystic Duct Cholangiography on Endoscopic Transpapillary Gallbladder Drainage in Acute Cholecystitis. Diagnostics (Basel) 2021; 11:diagnostics11071286. [PMID: 34359369 PMCID: PMC8307666 DOI: 10.3390/diagnostics11071286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/08/2021] [Accepted: 07/15/2021] [Indexed: 12/07/2022] Open
Abstract
Endoscopic transpapillary gallbladder drainage (ETGBD) for acute cholecystitis is challenging. We evaluated the influence of pre-procedural imaging and cystic duct cholangiography on ETGBD. Patients who underwent ETGBD for acute cholecystitis were retrospectively examined. The rate of gallbladder contrast on cholangiography, the accuracy of cystic duct direction and location by computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP), and the relationship between pre-procedural imaging and the technical success of ETGBD were investigated. A total of 145 patients were enrolled in this study. Gallbladder contrast on cholangiography was observed in 29 patients. The accuracy of cystic duct direction and location (proximal or distal, right or left, and cranial or caudal) by CT were, respectively, 79%, 60%, and 58% by CT and 68%, 55%, and 58% by MRCP. Patients showing gallbladder contrast on cholangiography underwent ETGBD with a significantly shorter procedure time and a lower rate of cystic duct injury. No other factors affecting procedure time, technical success, and cystic duct injury were identified. Pre-procedural evaluation of cystic duct direction and location by CT or MRCP was difficult in patients with acute cholecystitis. Patients who showed gallbladder contrast on cholangiography showed a shorter procedure time and a lower rate of cystic duct injury.
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10
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McCarty TR, Hathorn KE, Bazarbashi AN, Jajoo K, Ryou M, Thompson CC. Endoscopic gallbladder drainage for symptomatic gallbladder disease: a cumulative systematic review meta-analysis. Surg Endosc 2021; 35:4964-4985. [PMID: 34231061 DOI: 10.1007/s00464-020-07758-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/23/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Endoscopic ultrasound (EUS)-guided transmural or endoscopic retrograde cholangiography (ERC)-based transpapillary drainage may provide alternative treatment strategies for high-risk surgical candidates with symptomatic gallbladder (GB) disease. The primary aim of this study was to perform a systematic review and meta-analysis to investigate the efficacy and safety of endoscopic GB drainage for patients with symptomatic GB disease. METHODS Searches of PubMed, EMBASE, Web of Science, and Cochrane Library databases were performed in accordance with PRISMA and MOOSE guidelines. Pooled proportions were calculated for measured outcomes including technical success, clinical success, adverse event rate, recurrence rate, and rate of reintervention. Subgroup analyses were performed for transmural versus transpapillary, transmural lumen apposing stent (LAMS), and comparison to percutaneous transhepatic drainage. Heterogeneity was assessed with I2 statistics. Publication bias was ascertained by funnel plot and Egger regression testing. RESULTS Thirty-six studies (n = 1538) were included. Overall, endoscopic GB drainage achieved a technical and clinical success of 87.33% [(95% CI 84.42-89.77); I2 = 39.55] and 84.16% [(95% CI 80.30-87.38); I2 = 52.61], with an adverse event rate of 11.00% [(95% CI 9.25-13.03); I2 = 7.08]. On subgroup analyses, EUS-guided transmural compared to ERC-assisted transpapillary drainage resulted in higher technical and clinical success rates [OR 3.91 (95% CI 1.52-10.09); P = 0.005 and OR 4.59 (95% CI 1.84-11.46); P = 0.001] and lower recurrence rate [OR 0.17 (95% CI 0.06-0.52); P = 0.002]. Among EUS-guided LAMS studies, technical success was 94.65% [(95% CI 91.54-96.67); I2 = 0.00], clinical success was 92.06% [(95% CI 88.65-94.51); I2 = 0.00], and adverse event rate was 11.71% [(95% CI 8.92-15.23); I2 = 0.00]. Compared to percutaneous drainage, EUS-guided drainage possessed a similar efficacy and safety with significantly lower rate of reintervention [OR 0.05 (95% CI 0.02-0.13); P < 0.001]. DISCUSSION Endoscopic GB drainage is a safe and effective treatment for high-risk surgical candidates with symptomatic GB disease. EUS-guided transmural drainage is superior to transpapillary drainage and associated with a lower rate of reintervention compared to percutaneous transhepatic drainage.
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Affiliation(s)
- Thomas R McCarty
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.,Harvard Medical School, Boston, MA, 02115, USA
| | - Kelly E Hathorn
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.,Harvard Medical School, Boston, MA, 02115, USA
| | - Ahmad Najdat Bazarbashi
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.,Harvard Medical School, Boston, MA, 02115, USA
| | - Kunal Jajoo
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.,Harvard Medical School, Boston, MA, 02115, USA
| | - Marvin Ryou
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.,Harvard Medical School, Boston, MA, 02115, USA
| | - Christopher C Thompson
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. .,Harvard Medical School, Boston, MA, 02115, USA.
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11
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Maruta A, Iwashita T, Iwata K, Yoshida K, Uemura S, Mukai T, Yasuda I, Shimizu M. Permanent endoscopic gallbladder stenting versus removal of gallbladder drainage, long-term outcomes after management of acute cholecystitis in high-risk surgical patients for cholecystectomy: Multi-center retrospective cohort study. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2021; 28:1138-1146. [PMID: 33844472 DOI: 10.1002/jhbp.967] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/23/2021] [Accepted: 04/04/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Endoscopic transpapillary gallbladder drainage (EGBD) has been reported as an effective gallbladder drainage treatment option for acute cholecystitis in high-risk surgical patients. However, the long-term outcomes such as cholecystitis' recurrence rate after placement of EGB stenting (EGBS) have not been well studied yet. AIMS The aim of the present study was to compare the long-term outcome of EGBS and removal of gallbladder drainage after percutaneous transhepatic gallbladder drainage (PTGBD) or endoscopic nasogallbladder drainage (ENGBD) for acute cholecystitis in high-risk surgical patients and clarify the usefulness of long-term placement of EGBS. METHODS We retrospectively studied 180 high-risk surgical patients with acute cholecystitis between January 2010 and December 2018. The patients were divided into two groups: EGBS group (long-term placement of EGBS) or Removal group (removal of drainage tube after PTGBD or ENGBD). Clinical outcomes, including long-term results, were compared between the groups. RESULTS The cumulative late adverse event (AE) rates were 5.0% and 22.1% in the EGBS and Removal group (P = .002), with a median follow-up period of 375 and 307 days in the two groups, respectively. The cumulative cholecystitis recurrence rate was 5.0% (2/40) in the EGBS group and 16% (21/131) in the Removal group (P = .024), respectively. In the multivariate analysis for late AE, only EGBS was an independent risk factor with a decreasing value. CONCLUSION The permanent EGBS in high-risk surgical patients with acute cholecystitis was considered effective in reducing the risk of late AE.
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Affiliation(s)
- Akinori Maruta
- Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Takuji Iwashita
- First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Keisuke Iwata
- Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Kensaku Yoshida
- Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Shinya Uemura
- First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Tsuyoshi Mukai
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan
| | - Ichiro Yasuda
- Third Department of Internal Medicine, University of Toyama Hospital, Toyama, Japan
| | - Masahito Shimizu
- First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan
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12
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Mu P, Lin Y, Zhang X, Lu Y, Yang M, Da Z, Gao L, Mi N, Li T, Liu Y, Wang H, Wang F, Leung JW, Yue P, Meng W, Zhou W, Li X. The evaluation of ENGBD versus PTGBD in high-risk acute cholecystitis: A single-center prospective randomized controlled trial. EClinicalMedicine 2021; 31:100668. [PMID: 33385126 PMCID: PMC7772541 DOI: 10.1016/j.eclinm.2020.100668] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/11/2020] [Accepted: 11/17/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Gallbladder drainage plays a key role in the management of acute cholecystitis (AC) patients. Percutaneous transhepatic gallbladder drainage (PTGBD) is commonly used while endoscopic naso-gallbladder drainage (ENGBD) serves as an alternative. METHODS A single center, prospective randomized controlled trial was performed. Eligible AC patients were randomly assigned to ENGBD or PTGBD group. Randomization was a computer-generated list with 1:1 allocation. All patients received cholecystectomy 2-3 months after drainage. The primary endpoint was abdominal pain score, and the intention-to-treat population was analyzed. (ClinicalTrials.gov: NCT03701464). FINDINGS Between Oct 1, 2018 and Feb 29, 2020, 22 out of 61 consecutive AC patients were enrolled in the final analysis. The mean abdominal pain scores before drainage, and at 24, 48, and 72 h after drainage in ENGBD were 6.9 ± 1.1, 4.3 ± 1.2, 2.2 ± 0.8 and 1.5 ± 0.5, respectively, while those of PTGBD were 7.4 ± 1.2, 6.2 ± 1.2, 5.3 ± 1.0 and 3.7 ± 0.9; and the mean gallbladder area tenderness scores were 8.4 ± 1.2, 5.7 ± 0.9, 3.5 ± 0.7, 2.5 ± 0.5 for ENGBD and 8.6 ± 0.9, 7.3 ± 1.0, 7.4 ± 0.5, 4.8 ± 0.9 for PTGBD. The mean abdominal pain and gallbladder area tenderness scores of the ENGBD significantly decreased than the PTGBD (group × time interaction P<0.001, respectively). ENGBD group presented lower post-operative hemorrhage and abdominal drainage tube placement rates (median (IQR) 15[5-20] vs 40[20-70]ml, 3vs9, P = 0.03), and pathological grade and lymphocyte count were observed (P = 0.004) between groups. No adverse events were observed in 3 months follow-up. INTERPRETATION Compared to PTGBD, ENGBD group presented less pain, better gallbladder pathological grades and less surgical difficulties during cholecystectomy procedures. FUNDING National Natural Science Foundation of China (82060551).
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Affiliation(s)
- Peilei Mu
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Yanyan Lin
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Xianzhuo Zhang
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Yawen Lu
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Man Yang
- Department of Gastroenterology, Songgang People's Hospital, Shenzhen, Guangdong, China
| | - Zijian Da
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Long Gao
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Ningning Mi
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Tianya Li
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Ying Liu
- Foreign Languages Department of Lanzhou University, Lanzhou, China
| | - Haiping Wang
- Gansu Province Key Laboratory of Biological Therapy and Regenerative Medicine Transformation, Lanzhou, Gansu, China
| | - Fang Wang
- Department of Pathology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Joseph W. Leung
- Division of Gastroenterology and Hepatology, University of California, Davis Medical Center and Sacramento Veterans Affairs Medical Center, Sacramento, CA, United States
| | - Ping Yue
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Corresponding authors at: The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
| | - Wenbo Meng
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Province Key Laboratory of Biological Therapy and Regenerative Medicine Transformation, Lanzhou, Gansu, China
- Corresponding authors at: The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
| | - Wence Zhou
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Gansu Province Key Laboratory of Biological Therapy and Regenerative Medicine Transformation, Lanzhou, Gansu, China
- The Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Xun Li
- The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China
- Gansu Province Key Laboratory of Biological Therapy and Regenerative Medicine Transformation, Lanzhou, Gansu, China
- The Fifth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
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13
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Sagami R, Hayasaka K, Ujihara T, Nakahara R, Murakami D, Iwaki T, Suehiro S, Katsuyama Y, Harada H, Nishikiori H, Murakami K, Amano Y. Endoscopic transpapillary gallbladder drainage for acute cholecystitis is feasible for patients receiving antithrombotic therapy. Dig Endosc 2020; 32:1092-1099. [PMID: 32052507 DOI: 10.1111/den.13650] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 02/06/2020] [Accepted: 02/09/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Patients with acute cholecystitis receiving antithrombotic therapy (ATT) have an increased risk of bleeding complications during surgery and percutaneous drainage. Endoscopic transpapillary gallbladder drainage (ETGBD) is recommended for such cases; however, evidence is limited. To investigate this issue further, we performed a retrospective multicenter study. METHODS One hundred thirty patients with acute cholecystitis who underwent ETGBD were enrolled. They were divided into an ATT group (continuation of ATT on the day of the procedure and/or heparin substitution) and a Non-ATT group (discontinuation or no use of ATT). The primary outcome was bleeding complication rate, and the secondary outcomes were technical success rate, clinical success rate and total complication rate. RESULTS Eighty-three patients were enrolled in the ATT group, and 47 were enrolled in the Non-ATT group. In the ATT group, 42.2% continued multi-agent ATT. No bleeding complications occurred in either group. There were no significant differences between the ATT and Non-ATT groups in the technical success rate (84.3% vs 89.4%, P = 0.426 respectively) or the clinical success rate (97.1% vs 100%, P = 0.259, respectively). The overall early complication rate was 3.1% (4/130): mild pancreatitis (n = 3) and cholangitis (n = 1). Stent dysfunction was found in 10.9% of patients (at 196 days on average), and the 12-month stent patency rate was 69.0%. CONCLUSIONS No significant difference was found in the bleeding complication rate between ETGBD with and without ATT. ETGBD may be an ideal drainage method for patients with acute cholecystitis receiving ATT.
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Affiliation(s)
- Ryota Sagami
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Kenji Hayasaka
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Tetsuro Ujihara
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Ryotaro Nakahara
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Daisuke Murakami
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Tomoyuki Iwaki
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Satoshi Suehiro
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yasushi Katsuyama
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Hideaki Harada
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | | | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Yuji Amano
- Department of, Endoscopy, New Tokyo Hospital, Chiba, Japan
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14
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Sagami R, Hayasaka K, Ujihara T, Nakahara R, Murakami D, Iwaki T, Katsuyama Y, Harada H, Tsuji H, Sato T, Nishikiori H, Murakami K, Amano Y. Feasibility of endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis patients receiving antithrombotic therapy. Ann Gastroenterol 2020; 33:391-397. [PMID: 32624660 PMCID: PMC7315717 DOI: 10.20524/aog.2020.0496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/28/2020] [Indexed: 12/16/2022] Open
Abstract
Background Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) as a treatment for patients with acute cholecystitis has been shown to obtain high technical and clinical success rates and a low recurrence rate. However, the safety of EUS-GBD for patients receiving antithrombotic therapy (ATT) has not been proven. The aim was to evaluate the safety and efficacy of EUS-GBD in patients receiving ATT. Methods Twelve patients with acute cholecystitis associated with gallstones who were receiving antithrombotic therapy and underwent EUS-GBD were enrolled in this retrospective study. Patients with grade II or III cholecystitis who had failed endoscopic transpapillary GBD (ETGBD) or developed recurrence after multiple ETGBD procedures underwent urgent drainage by EUS-GBD. The primary outcome was the rate of bleeding complications after the procedure and the secondary outcomes were the technical and clinical success rates, complications, and recurrence. Results Eleven (91.6%) patients underwent EUS-GBD with continuation of ATT (at least 1 agent). Five of 12 patients (41.7%) were receiving more than 1 agent for ATT. The rate of bleeding complications was 0% and the technical success rate was 100%, even though some patients had high-grade (severe) cholecystitis and/or several underlying diseases. Early complications were found in 2 (16.7%) patients. The clinical success rate was 91.7% (11/12). There were no recurrences of cholecystitis during the follow-up period (mean 261 [range 5-650] days). Conclusions EUS-GBD yielded high technical and clinical success rates and a low recurrence rate. No patients receiving ATT developed bleeding complications. EUS-GBD might be a good option for patients on ATT.
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Affiliation(s)
- Ryota Sagami
- Department of Gastroenterology, Oita San-ai Medical Center, Oita (Ryota Sagami Hiroaki Tsuji, Takao Sato, Hidefumi Nishikiori)
| | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Ryotaro Nakahara
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Tomoyuki Iwaki
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Yasushi Katsuyama
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Hiroaki Tsuji
- Department of Gastroenterology, Oita San-ai Medical Center, Oita (Ryota Sagami Hiroaki Tsuji, Takao Sato, Hidefumi Nishikiori)
| | - Takao Sato
- Department of Gastroenterology, Oita San-ai Medical Center, Oita (Ryota Sagami Hiroaki Tsuji, Takao Sato, Hidefumi Nishikiori)
| | - Hidefumi Nishikiori
- Department of Gastroenterology, Oita San-ai Medical Center, Oita (Ryota Sagami Hiroaki Tsuji, Takao Sato, Hidefumi Nishikiori)
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University (Kazunari Murakami)
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba (Yuji Amano), Japan
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15
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Maruta A, Iwata K, Iwashita T, Yoshida K, Ando N, Toda K, Mukai T, Shimizu M. Factors affecting technical success of endoscopic transpapillary gallbladder drainage for acute cholecystitis. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2020; 27:429-436. [DOI: 10.1002/jhbp.744] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/10/2020] [Accepted: 03/23/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Akinori Maruta
- Department of Gastroenterology Gifu Prefectural General Medical Center Gifu Japan
| | - Keisuke Iwata
- Department of Gastroenterology Gifu Prefectural General Medical Center Gifu Japan
| | - Takuji Iwashita
- First Department of Internal Medicine Gifu University Hospital Gifu Japan
| | - Kensaku Yoshida
- Department of Gastroenterology Gifu Prefectural General Medical Center Gifu Japan
| | - Nobuhiro Ando
- Department of Gastroenterology Gifu Prefectural General Medical Center Gifu Japan
| | - Katsuhisa Toda
- Department of Gastroenterology Gifu Chuno Kosei Hospital Gifu Japan
| | - Tsuyoshi Mukai
- Department of Gastroenterology Gifu Municipal Hospital Gifu Japan
| | - Masahito Shimizu
- First Department of Internal Medicine Gifu University Hospital Gifu Japan
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16
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Han W, Yue Q, Liu K, Ke JJ, Meng LY, Liu YH. Endoscopic Nasogallbladder Drainage Combined with Laparoscopic Surgery for Type I Mirizzi Syndrome with Acute Cholecystitis: A Case Series Report. Gastroenterol Res Pract 2020; 2020:2417539. [PMID: 32328094 PMCID: PMC7165354 DOI: 10.1155/2020/2417539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 02/25/2020] [Accepted: 03/09/2020] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To investigate the safety and feasibility of endoscopic nasogallbladder drainage (ENGBD) combined with laparoscopic surgery for Mirizzi syndrome type I with acute cholecystitis. METHODS An analysis of 4 patients with type I Mirizzi syndrome with acute cholecystitis admitted to the First Hospital of Jilin University. RESULTS The patients underwent ENGBD, and laparoscopic surgery was evaluated postoperatively. All four patients successfully recovered from this combined surgical approach. CONCLUSION The combination of ENGBD and laparoscopic surgery is safe and feasible for the treatment of patients with type I Mirizzi syndrome accompanied by acute cholecystitis. This approach may reduce the traumatic stress on patients and is worthy of widespread implementation.
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Affiliation(s)
- Wei Han
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021 Jilin, China
| | - Qing Yue
- Department of Oncology, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021 Jilin, China
| | - Kai Liu
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021 Jilin, China
| | - Jian-ji Ke
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021 Jilin, China
| | - Ling-yu Meng
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021 Jilin, China
| | - Ya-hui Liu
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021 Jilin, China
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17
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Sagami R, Hayasaka K, Nishikiori H, Harada H, Amano Y. Current Status in the Treatment of Acute Cholecystitis Patients Receiving Antithrombotic Therapy: Is Endoscopic Drainage Feasible?- A Systematic Review. Clin Endosc 2020; 53:176-188. [PMID: 31914723 PMCID: PMC7137572 DOI: 10.5946/ce.2019.177] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 10/12/2019] [Indexed: 12/15/2022] Open
Abstract
The bleeding complication risk of surgery or percutaneous transhepatic gallbladder drainage (PTGBD) may increase in patients with acute cholecystitis receiving antithrombotic therapy (ATT). Endoscopic gallbladder drainage (EGBD) may be recommended for such patients. English articles published between 1991 and 2018 in peer-reviewed journals that discuss cholecystectomy, PTGBD, and EGBD in patients with ATT or coagulopathy were reviewed to assess the safety of the procedures, especially in terms of the bleeding complication. There were 8 studies on cholecystectomy, 3 on PTGBD, and 1 on endoscopic transpapillary gallbladder drainage (ETGBD) in patients receiving ATT. With respect to EGBD, 28 studies on ETGBD (including 1 study already mentioned above) and 26 studies on endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) were also analyzed. The overall bleeding complication rate in patients with ATT who underwent cholecystectomy was significantly higher than that in patients without ATT (6.5% [23/354] vs. 1.2% [26/2,224], p<0.001). However, the bleeding risk of cholecystectomy and PTGBD in patients receiving ATT was controversial. The overall technical success, clinical success, and bleeding complication rates of ETGBD vs. EUS-GBD were 84% vs. 96% (p<0.001), 92% vs. 97% (p<0.001), and 0.65% vs. 2.1% (p=0.005), respectively. One patient treated with ETGBD experienced bleeding complication among 191 patients with bleeding tendency. ETGBD may be an ideal drainage procedure for patients receiving ATT from the viewpoint of bleeding, although EUS-GBD is also efficacious.
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Affiliation(s)
- Ryota Sagami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | | | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
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18
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Nakahara K, Michikawa Y, Morita R, Suetani K, Morita N, Sato J, Tsuji K, Ikeda H, Matsunaga K, Watanabe T, Matsumoto N, Kobayashi S, Otsubo T, Itoh F. Endoscopic transpapillary gallbladder stenting using a newly designed plastic stent for acute cholecystitis. Endosc Int Open 2019; 7:E1105-E1114. [PMID: 31475227 PMCID: PMC6715425 DOI: 10.1055/a-0747-5668] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 09/04/2018] [Indexed: 12/23/2022] Open
Abstract
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.
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Affiliation(s)
- Kazunari Nakahara
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan,Corresponding author Kazunari Nakahara Department of Gastroenterology and HepatologySt. Marianna UniversitySchool of Medicine2-16-1, Sugao, Miyamae-kuKawasaki, 216-8511Japan+81-44-976-5805
| | - Yosuke Michikawa
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Ryo Morita
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Keigo Suetani
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Nozomi Morita
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Junya Sato
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Kensuke Tsuji
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Hiroki Ikeda
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Kotaro Matsunaga
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Tsunamasa Watanabe
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Nobuyuki Matsumoto
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Shinjiro Kobayashi
- Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Takehito Otsubo
- Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Fumio Itoh
- Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan
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Ogura T, Higuchi K. Endoscopic ultrasound-guided gallbladder drainage: Current status and future prospects. Dig Endosc 2019; 31 Suppl 1:55-64. [PMID: 30994239 DOI: 10.1111/den.13334] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/22/2018] [Indexed: 12/23/2022]
Abstract
Early surgical treatment using the laparoscopic approach is generally accepted as the treatment of choice for acute cholecystitis (AC) according to Tokyo Guidelines 2018 (TG2018). If the patient is a poor candidate for surgery because of the presence of advanced malignancy or severe organ failure, this treatment may be too invasive. In such cases, gallbladder drainage is considered an alternative treatment method to surgery. Several drainage methods have been established, such as percutaneous transhepatic gallbladder drainage (PTGBD) or endoscopic transpapillary gallbladder drainage (ETGBD) under endoscopic retrograde cholangiopancreatography (ERCP), including endoscopic naso-gallbladder drainage (ENGBD) and endoscopic gallbladder stenting (EGBS). PTGBD is a well-established procedure that is relatively easily carried out by general clinicians. And ETGBD has been developed as an alternative drainage method. The procedure also calls for guidewire passage across the cystic duct. Therefore, in AC cases who are contraindicated for surgery, PTGBD should be considered before ETGBD, and ETGBD may be considered only in high-volume institutes where expert hands are available, as described in the TG2018. However, there are several limitations to these procedures. Recently, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is increasingly being done as an alternative method to PTGBD and ETGBD. In this review, the current status and problems of EUS-GBD are reviewed, including technical review and clinical data of previous papers, current indication, long-term outcome, and comparison data with PTGBD or ETGBD, and their future prospects are discussed.
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Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Iino C, Shimoyama T, Igarashi T, Aihara T, Ishii K, Sakamoto J, Tono H, Fukuda S. Comparable efficacy of endoscopic transpapillary gallbladder drainage and percutaneous transhepatic gallbladder drainage in acute cholecystitis. Endosc Int Open 2018; 6:E594-E601. [PMID: 29744378 PMCID: PMC5940465 DOI: 10.1055/s-0044-102091] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 01/22/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND STUDY AIMS Although endoscopic transpapillary gallbladder drainage (ETGBD) is reportedly useful in patients who have acute cholecystitis, its efficacy has not been compared to that of percutaneous transhepatic gallbladder drainage (PTGBD). We retrospectively compared the efficacy and safety of ETGBD and PTGBD in patients with acute cholecystitis. PATIENTS AND METHODS We studied 75 patients who required gallbladder drainage for acute cholecystitis between January 2014 and December 2016. Using propensity score matching analysis, we compared the clinical efficacy and length of hospitalization in patients successfully treated with ETGBD and PTGBD. Moreover, we assessed the predictive factors for hospitalization period < 30 days using multivariate analysis. RESULTS ETGBD and PTGBD were successfully performed in 33 patients (77 %) and 42 patients (100 %) ( P < 0.001). Twenty-seven matched pairs were obtained after propensity score matching analysis. No significant differences were observed between patients treated with ETGBD and those treated with PTGBD with respect to improvement in white blood cell count and serum C-reactive protein level. The length of hospitalization in patients treated with ETGBD was significantly shorter than in those treated with PTGBD regardless of the need for surgery. Multivariate logistic regression analysis revealed ETGBD (odds ratio, 7.07; 95 % confidence interval 2.22 - 22.46) and surgery (odds ratio 0.26; 95 % confidence interval 0.09 - 0.79) as independent factors associated with hospitalization period. There were no significant differences in occurrence of complications in ETGBD and PTGBD procedure. CONCLUSIONS ETGBD was shown to be as useful as PTGBD for treatment of acute cholecystitis and was associated with shorter hospitalization period. ETGBD can be an alternative treatment option for acute cholecystitis at times when PTGBD is not possible.
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Affiliation(s)
- Chikara Iino
- Department of Gastroenterology and Hematology, Hirosaki National Hospital, Aomori, Japan,Department of Internal medicine, Hirosaki Municipal Hospital, Aomori, Japan,Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Aomori, Japan,Corresponding author Chikara Iino Department of Gastroenterology and HematologyHirosaki National Hospital1, TominochoOaza, Hirosaki, Aomori 036-8545, Japan+81-172-33-8614
| | - Tadashi Shimoyama
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Takasato Igarashi
- Department of Internal medicine, Hirosaki Municipal Hospital, Aomori, Japan,Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Tomoyuki Aihara
- Department of Internal medicine, Hirosaki Municipal Hospital, Aomori, Japan
| | - Kentaro Ishii
- Department of Internal medicine, Hirosaki Municipal Hospital, Aomori, Japan
| | - Juichi Sakamoto
- Department of Internal medicine, Hirosaki Municipal Hospital, Aomori, Japan
| | - Hiroshi Tono
- Department of Internal medicine, Hirosaki Municipal Hospital, Aomori, Japan
| | - Shinsaku Fukuda
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Aomori, Japan
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Khan MA, Atiq O, Kubiliun N, Ali B, Kamal F, Nollan R, Ismail MK, Tombazzi C, Kahaleh M, Baron TH. Efficacy and safety of endoscopic gallbladder drainage in acute cholecystitis: Is it better than percutaneous gallbladder drainage? Gastrointest Endosc 2017; 85:76-87.e3. [PMID: 27343412 DOI: 10.1016/j.gie.2016.06.032] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 06/12/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The efficacy and safety of endoscopic gallbladder drainage (EGBD) performed via endoscopic retrograde cholangiography (ERC)-based transpapillary stenting or EUS-based transmural stenting are unknown. We aimed to conduct a proportion meta-analysis to evaluate the cumulative efficacy and safety of these procedures and to compare them with percutaneous gallbladder drainage (PGBD). METHODS We searched several databases from inception through December 10, 2015 to identify studies (with 10 or more patients) reporting technical success and postprocedure adverse events of EGBD. Weighted pooled rates (WPRs) for technical and clinical success, postprocedure adverse events, and recurrent cholecystitis were calculated for both methods of EGBD. Pooled odds ratios (ORs) were also calculated to compare the technical success and postprocedure adverse events in patients undergoing EGBD versus PGBD. RESULTS The WPRs with 95% confidence intervals (CIs) of technical success, clinical success, postprocedure adverse events, and recurrent cholecystitis for ERC-based transpapillary drainage were 83% (95% CI, 78%-87%; I2 = 38%), 93% (95% CI, 89%-96%; I2 = 39%), 10% (95% CI, 7%-13%; I2 = 27%), and 3% (95% CI, 1%-5%; I2 = 0%), respectively. The WPRs for EUS-based drainage for technical success, clinical success, postprocedure adverse events, and recurrent cholecystitis were 93% (95% CI, 87%-96%; I2 = 0%), 97% (95% CI, 93%-99%; I2 = 0%), 13% (95% CI, 8%-19%; I2 = 0%), and 4% (95% CI, 2%-9%; I2 = 0%), respectively. On proportionate difference, EUS-based drainage had better technical (10%) and clinical success (4%) in comparison with ERC-based drainage. The pooled OR for technical success of EGBD versus PGBD was .51 (95% CI, .09-2.88; I2 = 23%) and for postprocedure adverse events was .33 (95% CI, .14-.80; I2 = 16%) in favor of EGBD. CONCLUSIONS EGBD is an efficacious and safe therapeutic modality for treatment of patients with acute cholecystitis who cannot undergo surgery. EGBD shows a similar technical success as PGBD but appears to be safer than PGBD.
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Affiliation(s)
- Muhammad Ali Khan
- Division of Gastroenterology and Hepatology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Omair Atiq
- Division of Digestive and Liver Diseases, University of Texas, Southwestern Medical Center, Dallas, Texas, USA
| | - Nisa Kubiliun
- Division of Digestive and Liver Diseases, University of Texas, Southwestern Medical Center, Dallas, Texas, USA
| | - Bilal Ali
- Division of Gastroenterology and Hepatology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Faisal Kamal
- Division of Gastroenterology and Hepatology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Richard Nollan
- University of Tennessee Health Science Center Library, Memphis, Tennessee, USA
| | - Mohammad Kashif Ismail
- Division of Gastroenterology and Hepatology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Claudio Tombazzi
- Division of Gastroenterology and Hepatology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Michel Kahaleh
- Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, New York, USA
| | - Todd H Baron
- Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
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22
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Yang MJ, Yoo BM, Kim JH, Hwang JC, Baek NH, Kim SS, Lim SG, Kim JH, Shin SJ, Cheong JY, Lee KM, Lee KJ, Kim WH, Cho SW. Endoscopic naso-gallbladder drainage versus gallbladder stenting before cholecystectomy in patients with acute cholecystitis and a high suspicion of choledocholithiasis: a prospective randomised preliminary study. Scand J Gastroenterol 2016; 51:472-8. [PMID: 26595503 DOI: 10.3109/00365521.2015.1115116] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Endoscopic transpapillary gallbladder drainage using a nasocystic tube or plastic stent has been attempted as an alternative to percutaneous drainage for patients with acute cholecystitis who are not candidates for urgent cholecystectomy. We aimed to assess the efficacy of single-step endoscopic drainage of the common bile duct and gallbladder, and to evaluate which endoscopic transpapillary gallbladder drainage method is ideal as a bridge before elective cholecystectomy. MATERIALS AND METHODS From July 2011 to December 2014, 35 patients with acute moderate-to-severe cholecystitis and a suspicion of choledocholithiasis were randomly assigned to the endoscopic naso-gallbladder drainage (ENGBD) (n = 17) or endoscopic gallbladder stenting (EGBS) (n = 18) group. RESULTS Bile duct clearance was performed successfully in all cases. No significant differences were found between the ENGBD and EGBS groups in the technical success rates [82.4% (14/17) vs. 88.9% (16/18), p = 0.658] and clinical success rates [by intention-to-treat analysis: 70.6% (12/17) vs. 83.3% (15/18), p = 0.443; by per protocol analysis of technically feasible cases: 85.7% (12/14) vs. 93.8% (15/16), p = 0.586]. Three ENGBD patients and two EGBS patients experienced adverse events (p = 0.658). No significant differences were found in operation time or rate of conversion to open cholecystectomy. CONCLUSIONS Single-step endoscopic transpapillary drainage of the common bile duct and gallbladder seems to be an acceptable therapeutic modality in patients with acute cholecystitis and a suspicion of choledocholithiasis. There were no significant differences in the technical and clinical outcomes between ENGBD and EGBS as a bridge before cholecystectomy.
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Affiliation(s)
- Min Jae Yang
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
| | - Byung Moo Yoo
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
| | - Jin Hong Kim
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
| | - Jae Chul Hwang
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
| | - Nam Hyun Baek
- b Department of Surgery , Ajou University School of Medicine , Suwon , South Korea
| | - Soon Sun Kim
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
| | - Sun Gyo Lim
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
| | - Ji Hun Kim
- b Department of Surgery , Ajou University School of Medicine , Suwon , South Korea
| | - Sung Jae Shin
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
| | - Jae Youn Cheong
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
| | - Kee Myung Lee
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
| | - Kwang Jae Lee
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
| | - Wook Hwan Kim
- b Department of Surgery , Ajou University School of Medicine , Suwon , South Korea
| | - Sung Won Cho
- a Department of Gastroenterology , Ajou University School of Medicine , Suwon , South Korea
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Lee DW, Kim HG. Can Endoscopic Nasobiliary Drainage Involving Two Catheters Be Used to Treat Various Conditions? Clin Endosc 2015; 48:464-5. [PMID: 26668790 PMCID: PMC4676669 DOI: 10.5946/ce.2015.48.6.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 11/17/2015] [Accepted: 11/17/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Dong Wook Lee
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Ho Gak Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
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24
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Woo YS, Lee JK. Endoscopic nasogallbladder drainage in patients with acute cholecystitis: what's predictive factor for technical success? Gut Liver 2015; 9:141-2. [PMID: 25721000 PMCID: PMC4351018 DOI: 10.5009/gnl15010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Young Sik Woo
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Kyun Lee
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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