Format

Send to

Choose Destination
Dig Liver Dis. 2016 Sep;48(9):1054-7. doi: 10.1016/j.dld.2016.05.021. Epub 2016 Jun 3.

International collaborative study on EUS-guided gallbladder drainage: Are we ready for prime time?

Author information

1
Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, United States. Electronic address: mkahaleh@gmail.com.
2
Hospital del Rio Hortega, Rio Hortega, Spain.
3
University of Sao Paulo, Sao Paulo, Brazil.
4
Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, United States.
5
Staten Island University Hospital, Staten Island, NY, United States.
6
Institute Paoli-Calmettes, Marseille, France.

Abstract

BACKGROUND:

Cholecystectomy remains the gold standard treatment of cholecystitis. Endoscopic treatment of cholecystitis includes transpapillary gallbladder drainage. Recently, endoscopic ultrasound-guided transmural drainage of the gallbladder (EUS-GBD) has been reported. This study reports the cumulative experience of an international group performing EUS-GBD.

METHODS:

Cases of EUS-GBD from January 2012 to November 2013 from 3 tertiary-care institutions were captured in a registry. Patient demographics, disease characteristics, procedural and clinical outcomes were recorded.

RESULTS:

35 patients (15 malignant, 20 benign) were included. Median age was 81 years (SD=13.76 years), sixteen (46%) were males. Median follow-up was 91.5 days (SD=157 days). Transmural access was obtained from the stomach (n=17) or duodenum (n=18). Stents placed included plastic (n=6), metal (n=20), or combination (n=7). Technical success was achieved in 91.4% (n=32). Immediate adverse events (14%) included: bleeding, stent migration, cholecystitis and hemoperitoneum. Delayed adverse events (11%) included abscess formation and recurrence of cholecystitis. Long-term clinical success rate was 89%. Stent type and puncture site were not associated with immediate (p=0.88, p=0.62), or long-term (p=0.47, p=0.27) success.

CONCLUSIONS:

EUS-GBD appears to be feasible, safe, and effective. Prospective studies are needed to confirm these findings and identify the best technique to use.

CLINICAL TRIAL REGISTRATION:

NCT01522573.

KEYWORDS:

Cholecytitis; EUS; EUS-GBD; Endoscopic gallbladder drainage; Endoscopic ultrasound; Gallbladder drainage

PMID:
27328985
DOI:
10.1016/j.dld.2016.05.021
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center