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Hamaoka M, Kitamura Y, Shinohara M, Hashimoto M, Miguchi M, Misumi T, Fujikuni N, Ikeda S, Matsugu Y, Nakahara H. Surgical outcomes of patients with acute cholecystitis treated with gallbladder drainage followed by early cholecystectomy. Asian J Surg 2024:S1015-9584(24)01059-5. [PMID: 38824020 DOI: 10.1016/j.asjsur.2024.05.168] [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: 02/19/2024] [Accepted: 05/24/2024] [Indexed: 06/03/2024] Open
Abstract
AIM This study aimed to investigate the impact of preoperative gallbladder drainage and the specific drainage method used on surgical outcomes in patients undergoing surgery for acute cholecystitis. METHODS This single-center retrospective cohort study included 221 patients who underwent early cholecystectomy between January 2016 and December 2020. Clinical data and outcomes of 140 patients who did not undergo drainage, 22 patients who underwent preoperative percutaneous transhepatic gallbladder drainage (PTGBD), and 59 patients who underwent preoperative endoscopic naso-gallbladder drainage (ENGBD) were compared. RESULTS There was no difference in the operation time, blood loss, postoperative complications, or length of postoperative hospital stay between patients who did and did not undergo drainage. Among patients who underwent drainage, there was no difference between the ENGBD and PTGBD groups in operation time, blood loss, or postoperative complications; however, more patients in the PTGBD group underwent laparotomy and had a significantly longer postoperative hospital stay. The presence and type of drainage were not risk factors for postoperative complications. CONCLUSION The presence or absence of preoperative gallbladder drainage for acute cholecystitis and the type of drainage may not significantly affect surgical outcomes.
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Affiliation(s)
- Michinori Hamaoka
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan.
| | - Yoshihito Kitamura
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Makoto Shinohara
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Masakazu Hashimoto
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Masashi Miguchi
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Toshihiro Misumi
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Nobuaki Fujikuni
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Satoshi Ikeda
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Yasuhiro Matsugu
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Hideki Nakahara
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan
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Hayakawa T, Iwasaki E, Okada H, Nakajima Y, Kayashima A, Kawasaki S, Horibe M, Kanai T. Efficacy of a novel ultra-tapered endoscopic nasobiliary drainage tube in gallbladder drainage. VIDEOGIE : AN OFFICIAL VIDEO JOURNAL OF THE AMERICAN SOCIETY FOR GASTROINTESTINAL ENDOSCOPY 2024; 9:208-210. [PMID: 38618615 PMCID: PMC11009447 DOI: 10.1016/j.vgie.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Affiliation(s)
- Takaoki Hayakawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Haruka Okada
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Yuki Nakajima
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Atsuto Kayashima
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Shintaro Kawasaki
- Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan
| | - Masayasu Horibe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, 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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Manudhane AP, Leupold MD, Shah HW, Shah R, Han SY, Lee PJ, Burlen JJ, Papachristou GI, Krishna SG. A Review on Endoscopic Management of Acute Cholecystitis: Endoscopic Ultrasound-Guided Gallbladder Drainage and Endoscopic Transpapillary Gallbladder Drainage. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:212. [PMID: 38399500 PMCID: PMC10890498 DOI: 10.3390/medicina60020212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/20/2024] [Accepted: 01/21/2024] [Indexed: 02/25/2024]
Abstract
A percutaneous cholecystostomy tube (PCT) is the conventionally favored nonoperative intervention for treating acute cholecystitis. However, PCT is beset by high adverse event rates, need for scheduled reintervention, and inadvertent dislodgement, as well as patient dissatisfaction with a percutaneous drain. Recent advances in endoscopic therapy involve the implementation of endoscopic transpapillary drainage (ETP-GBD) and endoscopic ultrasound-guided gallbladder drainage (EUS-GBD), which are increasingly preferred over PCT due to their favorable technical and clinical success combined with lower complication rates. In this article, we provide a comprehensive review of the literature on EUS-GBD and ETP-GBD, delineating instances when clinicians should opt for endoscopic management and highlighting potential risks associated with each approach.
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Affiliation(s)
- Albert P. Manudhane
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 262, Columbus, OH 43210, USA; (A.P.M.)
| | - Matthew D. Leupold
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Hamza W. Shah
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 262, Columbus, OH 43210, USA; (A.P.M.)
| | - Raj Shah
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 262, Columbus, OH 43210, USA; (A.P.M.)
| | - Samuel Y. Han
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 262, Columbus, OH 43210, USA; (A.P.M.)
| | - Peter J. Lee
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 262, Columbus, OH 43210, USA; (A.P.M.)
| | - Jordan J. Burlen
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 262, Columbus, OH 43210, USA; (A.P.M.)
| | - Georgios I. Papachristou
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 262, Columbus, OH 43210, USA; (A.P.M.)
| | - Somashekar G. Krishna
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 262, Columbus, OH 43210, USA; (A.P.M.)
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Kurihara H, Binda C, Cimino MM, Manta R, Manfredi G, Anderloni A. Acute cholecystitis: Which flow-chart for the most appropriate management? Dig Liver Dis 2023; 55:1169-1177. [PMID: 36890051 DOI: 10.1016/j.dld.2023.02.005] [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: 10/01/2022] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 03/10/2023]
Abstract
Acute cholecystitis (AC) is a very common disease in clinical practice. Laparoscopic cholecystectomy remains the gold standard treatment for AC, however due to aging population, the increased prevalence of multiple comorbidities and the extensive use of anticoagulants, surgical procedures may be too risky when dealing with patients in emergency settings. In these subsets of patients, a mini-invasive management may be an effective option, both as a definitive treatment or as bridge-to-surgery. In this paper, several non-operative treatments are described and their benefits and drawbacks are highlighted. Percutaneous gallbladder drainage (PT-GBD) is one of the most common and widespread techniques. It is easy to perform and has a good cost/benefit ratio. Endoscopic transpapillary gallbladder drainage (ETGBD) is a challenging procedure that is usually performed in high volume centers by expert endoscopists, and it has a specific indication for selected cases. EUS-guided drainage (EUS-GBD) is still not widely available, but it is an effective procedure that could have several advantages, especially in rate of reinterventions. All these treatment options should be considered together in a stepwise approach and addressed to patients after an accurate case-by-case evaluation in a multidisciplinary discussion. In this review, we provide a possible flowchart in order to optimize treatments, resource and provide to patients a tailored approach.
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Affiliation(s)
- Hayato Kurihara
- Emergency Surgery Unit, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cecilia Binda
- Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Italy
| | - Matteo Maria Cimino
- Emergency Surgery Unit, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Raffaele Manta
- Endoscopic Unit, Santa Maria Misericordia Hospital, Perugia 06122, Italy
| | - Guido Manfredi
- Gastroenterology and Endoscopy Department, ASST Maggiore Hospital Crema, Italy
| | - Andrea Anderloni
- Gastroenterology and Digestive Endoscopy Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Viale Camillo Golgi 19, Pavia 27100, Italy.
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Sato J, Nakahara K, Michikawa Y, Suetani K, Igarashi Y, Sekine A, Satta Y, Kobayashi S, Otsubo T, Tateishi K. Long-term outcomes of endoscopic transpapillary gallbladder drainage using a novel spiral plastic stent in acute calculus cholecystitis. BMC Gastroenterol 2022; 22:539. [PMID: 36564715 PMCID: PMC9784005 DOI: 10.1186/s12876-022-02610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Endoscopic transpapillary gallbladder stenting (EGBS) is considered for patients with contraindications to early surgery for acute calculus cholecystitis. However, evidence regarding the long-term outcomes of EGBS is insufficient to date. The aim of the study was to evaluate the feasibility of EGBS as a bridge to or alternative to surgery when there are contraindications. METHODS We reviewed the cases of patients who underwent EGBS using a novel spiral-shaped plastic stent for acute calculus cholecystitis between January 2011 and December 2019. We retrospectively evaluated the long-term outcomes of EGBS using a novel spiral-shaped plastic stent. RESULTS Forty-nine patients were included. The clinical success rate of EGBS was 97%. After EGBS, 25 patients (surgery group) underwent elective cholecystectomy and 24 patients did not (follow-up group). In the surgery group, the median period from EGBS to surgery was 93 days. There was a single late adverse event with cholecystitis recurrence. In the follow-up group, the median follow-up period was 236 days. Late adverse events were observed in eight patients, including recurrence of cholecystitis (four patients), duodenal penetration by the distal stent end (two patients), and distal stent migration (two patient). In the follow-up group, the time to recurrence of biliary obstruction was 527 days. CONCLUSIONS EGBS with a novel spiral-shaped plastic stent is safe and effective for long-term acute calculus cholecystitis. There is a possibility of EGBS to be a bridge to surgery and a surgical alternative for acute calculus cholecystitis in patients with contraindications to early cholecystectomy.
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Affiliation(s)
- Junya Sato
- grid.412764.20000 0004 0372 3116Department of Gastroenterology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa Japan
| | - Kazunari Nakahara
- grid.412764.20000 0004 0372 3116Department of Gastroenterology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa Japan
| | - Yosuke Michikawa
- grid.412764.20000 0004 0372 3116Department of Gastroenterology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa Japan
| | - Keigo Suetani
- grid.412764.20000 0004 0372 3116Department of Gastroenterology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa Japan
| | - Yosuke Igarashi
- grid.412764.20000 0004 0372 3116Department of Gastroenterology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa Japan
| | - Akihiro Sekine
- grid.412764.20000 0004 0372 3116Department of Gastroenterology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa Japan
| | - Yusuke Satta
- grid.412764.20000 0004 0372 3116Department of Gastroenterology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa Japan
| | - Shinjiro Kobayashi
- grid.412764.20000 0004 0372 3116Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa Japan
| | - Takehito Otsubo
- grid.412764.20000 0004 0372 3116Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa Japan
| | - Keisuke Tateishi
- grid.412764.20000 0004 0372 3116Department of Gastroenterology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa Japan
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Endoscopic ultrasound in the management of acute cholecystitis. Best Pract Res Clin Gastroenterol 2022; 60-61:101806. [PMID: 36577527 DOI: 10.1016/j.bpg.2022.101806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022]
Abstract
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is increasingly utilised for patients with acute cholecystitis who are high-risk candidates for surgery. The technique to perform EUS-GBD has evolved and matured over the last two decades since EUS-GBD was first described in 2007 using a nasobiliary catheter. Compared to percutaneous gallbladder drainage (PT-GBD), EUS-GBD offers benefits of shorter hospitalisation stay and lesser procedural pain and need for reintervention. The purpose of this review is to provide an updated review of the equipment and techniques available for EUS-GBD, outcomes of the procedure and how it compares against endoscopic transpapillary drainage (ET-GBD), PT-GBD and laparoscopic cholecystectomy. Controversies surrounding the procedure will also be discussed.
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Takenaka M, Fukunishi K, Takashima K, Yamazaki T, Kudo M. Efficacy of an easy loop-forming guidewire in endoscopic transpapillary gallbladder drainage with gallstones impacted in the cystic duct. Endoscopy 2022; 54:E1078-E1080. [PMID: 36049769 PMCID: PMC9738054 DOI: 10.1055/a-1893-5590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Mamoru Takenaka
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Kae Fukunishi
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Kota Takashima
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Tomohiro Yamazaki
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
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Abstract
Endoscopic drainage of the gallbladder for acute cholecystitis can be performed with the transpapillary method or endoscopic ultrasound (EUS)-guided method. EUS-guided gallbladder drainage (EUS-GBD) is gaining popularity as the treatment of choice for acute cholecystitis in patients who are deemed high-risk for cholecystectomy (CCY). It provides an alternative to percutaneous drainage and laparoscopic CCY in these patients. With the development of lumen-apposing metal stents (LAMS), the procedure is associated with high rates of technical and clinical success with low rates of adverse events (AEs). The aim of this article is to provide an overview of the current status of EUS-GBD including the indications, techniques, stent systems in-use, and how the procedure compares to conventional techniques are outlined. Furthermore, the feasibility of cholecystoscopy and advanced gallbladder interventions is explored. Finally, a comparison in outcomes of EUS-GBD versus laparoscopic CCY is provided giving some initial data in support of the procedure as an alternative to surgery in a selected group of patients.
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Affiliation(s)
- Xiaobei Luo
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Reem Sharaiha
- Division of Gastroenterology and Hepatology, New York Presbyterian Hospital/Weill Cornell Medical Centre, New York, NY, USA
| | - Anthony Yuen Bun Teoh
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Ban T, Kubota Y, Takahama T, Ando T, Joh T. Soehendra stent retriever as a useful delivery device of drainage stent for passing an impacted cystic duct stone in a patient with acute cholecystitis. DEN OPEN 2022; 2:e78. [PMID: 35310756 PMCID: PMC8828182 DOI: 10.1002/deo2.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 12/07/2022]
Abstract
Endoscopic transpapillary gallbladder drainage is an alternative procedure for patients with acute cholecystitis. However, this procedure is technically challenging because the drainage stent is sometimes obstructed by an impacted cystic duct stone, even if the guidewire is advanced into the gallbladder. In this report, the front end of a standard endoscopic retrograde cholangiopancreatography catheter was cut to an appropriate length as a drainage stent for transpapillary gallbladder drainage. However, this modified stent became stuck because of an impacted cystic duct stone. The Soehendra stent retriever was used as a stent delivery device in this setting. A Soehendra stent retriever with clockwise rotation was coupled with the drainage stent. Integrated devices provide a stent tip for pushability and torqueability. The stuck drainage stent at the impacted cystic duct stone resumed advancement into the gallbladder. After stent indwelling, decoupling was easy under counterclockwise rotation of the Soehendra stent retriever.
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Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
| | - Tomoaki Ando
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
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