Initial Experience with Endoscopic Ultrasound-guided Gallbladder Drainage

Overview

Journal Wideochir Inne Tech Maloinwazyjne

Publisher Termedia

Date 2019 May 24

PMID 31118983

Citations 4

Authors

Sebastian Sowier

Aleksander Sowier

Anna Wiechowska-Kozlowska

Jacek Bialecki

Przemyslaw Pyda

Affiliations

Soon will be listed here.

Abstract

Introduction: Patients with acute cholecystitis who are unsuitable for cholecystectomy undergo conservative treatment or percutaneous transhepatic gallbladder drainage. As these two methods are not always successful, further treatment options are needed. One increasingly popular method is endoscopic ultrasound-guided gallbladder drainage (EUSGBD), whereby stents are placed so as to create a permanent fistula connecting the gallbladder to the stomach or the duodenal bulb, thus enabling drainage of its contents to the gastrointestinal tract.

Aim: To present our early experience with EUSGBD for the treatment of cholecystitis in patients who are not suitable for cholecystectomy.

Material And Methods: The procedure was performed in 5 patients with acute cholecystitis. Two patients also had symptoms of biliary obstruction due to pancreatic head cancer. An ultrasound endoscope was used to create a fistula between the gallbladder and the stomach or between the gallbladder and the duodenal bulb, in which a self-expandable metallic stent (SEMS) was placed.

Results: All procedures were performed with no perioperative complications. In all patients, the clinical symptoms of cholecystitis subsided within 3-15 days. In those patients who also showed symptoms of biliary obstruction, these symptoms subsided within 3-6 days following the procedure.

Conclusions: The EUSGBD seems to be an effective and safe treatment for acute cholecystitis in patients unsuitable for cholecystectomy. It can also be used to treat jaundice caused by obstruction of the common bile duct, when no other methods can be used. The method is particularly promising in cases of concurrent acute cholecystitis and common bile duct obstruction.

Citing Articles

Determinants of outcomes of transmural EUS-guided gallbladder drainage: systematic review with proportion meta-analysis and meta-regression.

Fabbri C, Binda C, Sbrancia M, Dajti E, Coluccio C, Ercolani G Surg Endosc. 2022; 36(11):7974-7985.

PMID: 35652964 DOI: 10.1007/s00464-022-09339-y.

Reconsideration of indications for choledochoscopic gallbladder-preserving surgery and preventive measures for postoperative recurrence of gallstones.

Du Q, Wang Y, Hu C, Zhou Y Wideochir Inne Tech Maloinwazyjne. 2020; 15(1):87-96.

PMID: 32117490 PMC: 7020701. DOI: 10.5114/wiitm.2019.88647.

Evaluation of the usefulness of the SAGES Safe Cholecystectomy Program from the viewpoint of the European surgeon.

Bogacki P, Krzak J, Gotfryd-Bugajska K, Szura M Wideochir Inne Tech Maloinwazyjne. 2020; 15(1):80-86.

PMID: 32117489 PMC: 7020732. DOI: 10.5114/wiitm.2019.83297.

Excision of a part of the bile duct as an iatrogenic injury typical for laparoscopic cholecystectomy - characteristics, treatment and long-term results, based on own material.

Durowicz S, Kozicki I, Ciesielski A, Tarnowski W Wideochir Inne Tech Maloinwazyjne. 2020; 15(1):70-79.

PMID: 32117488 PMC: 7020707. DOI: 10.5114/wiitm.2019.85806.

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