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| Efficacy and safety of conversion of percutaneous cholecystostomy to endoscopic transpapillary gallbladder stenting in high-risk surgical patients |
| Hyung Ku Chon a , b , # , Chan Park c , # , Dong Eun Park c , Tae Hyeon Kim a , b , ∗ |
a Division of Biliopancreas, Department of Internal Medicine, Wonkwang University College of Medicine and Hospital, 895 MuwangRo, Iksan, South Korea
b Institute of Wonkwang Medical Science, Wonkwang University College of Medicine and Hospital, Iksan, South Korea
c Department of Surgery, Wonkwang University College of Medicine and Hospital, Iksan, South Korea
∗ Corresponding author at: Division of Biliopancreas, Department of Internal Medicine, Wonkwang University College of Medicine and Hospital, 895 MuwangRo, Iksan, South Korea.
E-mail address: kth@wku.ac.kr (T.H. Kim).
# Contributed equally. |
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Abstract Background: Endoscopic transpapillary gallbladder stenting (ETGBS) has been used as an alternative to percutaneous cholecystostomy in patients with acute cholecystitis who are considered unfit for surgery. However, there are few data on the efficacy and safety of ETGBS replacement of percutaneous cholecystostomy in high-risk surgical patients. This study aimed to evaluate the feasibility, efficacy, and safety of ETGBS to replace percutaneous cholecystostomy in high-risk surgical patients.
Methods: This single center retrospective study reviewed the data of patients who attempted ETGBS to replace percutaneous cholecystostomy between January 2017 and September 2019. The technical success, clinical success, adverse events, and stent patency were evaluated.
Results: ETGBS was performed in 43 patients (24 male, mean age 80.7 ±7.4 years) to replace percutaneous cholecystostomy due to high surgical risk. The technical success rate and clinical success rate were 97.7% (42/43) and 90.5% (38/42), respectively. Procedure-related adverse events and stent-related late adverse events occurred in 7.0% (3/43) and 11.6% (5/43), respectively. Of the patients who successfully underwent ETGBS ( n = 42), only one had recurrent acute cholecystitis during follow-up. The median stent patency was 415 days (interquartile range 240–528 days).
Conclusions: ETGBS, as a secondary intervention for the purpose of internalizing gallbladder drainage in patients following placement of a percutaneous cholecystostomy, is safe, effective, and technically feasible. Thus, conversion of percutaneous cholecystostomy to ETGBS may be considered as a viable option in high-risk surgical patients.
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2021, Vol. 20 
