Endoscopic Ultrasound-Guided Gallbladder Drainage Using a Lumen-Apposing Metal Stent for Acute Cholecystitis: A Systematic Review

Clinical Endoscopy
Deepanshu JainShashideep Singhal

Abstract

Surgery remains the standard treatment for acute cholecystitis except in high-risk candidates where percutaneous transhepatic gallbladder drainage (PT-GBD), endoscopic transpapillary cystic duct stenting (ET-CDS), and endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) are potential choices. PT-GBD is contraindicated in patients with coagulopathy or ascites and is not preferred by patients owing to aesthetic reasons. ET-CDS is successful only if the cystic duct can be visualized and cannulated. For 189 patients who underwent EUS-GBD via insertion of a lumen-apposing metal stent (LAMS), the composite technical success rate was 95.2%, which increased to 96.8% when LAMS was combined with co-axial self-expandable metal stent (SEMS). The composite clinical success rate was 96.7%. We observed a small risk of recurrent cholecystitis (5.1%), gastrointestinal bleeding (2.6%) and stent migration (1.1%). Cautery enhanced LAMS significantly decreases the stent deployment time compared to non-cautery enhanced LAMS. Prophylactic placement of a pigtail stent or SEMS through the LAMS avoids re-interventions, particularly in patients, where it is intended to remain in situ indefinitely. Limited evidence suggests that the efficacy of EUS...Continue Reading

References

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Citations

Sep 28, 2018·Clinical Endoscopy·Deepanshu JainShashideep Singhal
Nov 2, 2018·F1000Research·Bryan Balmadrid
Aug 5, 2020·Digestive Diseases and Sciences·Zain A SobaniTarun Rustagi
Dec 21, 2018·World Journal of Gastrointestinal Pharmacology and Therapeutics·Umesha BoregowdaShreyas Saligram
Jun 12, 2020·Clinical and Experimental Gastroenterology·Alessandro FugazzaAndrea Anderloni
Jul 19, 2019·Current Treatment Options in Gastroenterology·Jennifer T Higa, Shayan S Irani
Jan 4, 2020·Endoscopic Ultrasound·Anthony Yuen Bun Teoh
Aug 22, 2020·ACG Case Reports Journal·Hicham El BachaFrederic Prat
Aug 17, 2019·Endoscopic Ultrasound·Barbara BradenChristoph Frank Dietrich
Nov 12, 2020·Journal of Clinical Medicine·Se Woo Park, Sang Soo Lee
Dec 16, 2020·VideoGIE : an Official Video Journal of the American Society for Gastrointestinal Endoscopy·Jennifer T Higa, Shayan S Irani
Jul 19, 2021·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Se Woo Park, Sang Soo Lee
Jun 7, 2021·Current Opinion in Gastroenterology·Christoph F DietrichChristian Jenssen
Aug 17, 2021·Seminars in Interventional Radiology·Matthew AntalekAlbert A Nemcek

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